Number of metastases, serum lactate dehydrogenase level, and type of treatment are prognostic factors in patients with brain metastases of malignant melanoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Thomas K. Eigentler - , University of Tübingen (Author)
  • Adina Figl - , Heidelberg University  (Author)
  • Dietmar Krex - , Department of Neurosurgery, TUD Dresden University of Technology (Author)
  • Peter Mohr - , Elbe Clinics Stade/Buxtehude (Author)
  • Cornelia Mauch - , University of Cologne (Author)
  • Knut Rass - , Saarland University (Author)
  • Azize Bostroem - , University of Bonn (Author)
  • Oliver Heese - , University of Hamburg (Author)
  • Oliver Koelbl - , University of Regensburg (Author)
  • Claus Garbe - , University of Tübingen (Author)
  • Dirk Schadendorf - , University of Duisburg-Essen (Author)

Abstract

Background: This multicenter study aimed to identify prognostic factors in patients with brain metastases from malignant melanoma (BM-MM). Methods: In a retrospective survey in 9 cancer centers of the German Cancer Society, 692 patients were identified with BM-MM during the period 1986 through 2007. Overall survival was analyzed using a Kaplan-Meier estimator and compared with log-rank analysis. Cox proportional hazards models were used to identify prognostic factors significant for survival. Results: The median overall survival of the entire cohort was 5.0 months (95% confidence interval [95% CI], 4 months-5 months). Significant prognostic factors in the univariate Kaplan-Meier analysis were Karnofsky performance status (≥70% vs <70%; P <.001), number of BM-MM (single vs multiple; P <.001), pretreatment levels of lactate dehydrogenase (LDH) (normal vs elevated; P <.001) and S-100 (normal vs elevated; P <.001), prognostic groups according to Radiation Therapy Oncology Group (class I vs class II vs class III; P =.0485), and treatment choice (for the cohort with single BM-MM only) (stereotactic radiotherapy or neurosurgical metastasectomy vs others; P =.036). Cox proportional hazards models revealed pretreatment elevated level of serum LDH (hazard ratio [HR], 1.6; 95% CI, 1.3-2.0 [P =.00013]) and number of BM-MM (HR, 1.6; 95% CI, 1.3-2.0 [P =.00011]) to be independent prognostic variables in the entire cohort, whereas in patients with a single BM-MM, treatment choice (HR, 1.5; 95% CI, 1.1-1.9 [P =.0061]) was identified as a unique prognostic factor. Conclusions: The overall survival of patients with BM-MM primarily depends on the number of metastases and pretreatment level of LDH. In the case of a single brain metastasis, stereotactic radiotherapy or neurosurgical metastasectomy is by far the most important factor for improving survival.

Details

Original languageEnglish
Pages (from-to)1697-1703
Number of pages7
JournalCancer
Volume117
Issue number8
Publication statusPublished - 15 Apr 2011
Peer-reviewedYes

External IDs

PubMed 21472716

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • brain metastasis, melanoma, neurosurgery, prognostic factors, serum lactate dehydrogenase, stereotactic radiosurgery, survival