Prognostic factors in malignant melanoma patients with solitary or multiple brain metastases: Is there a role for surgery?

Background. The aim of this study is to evaluate the prognostic parameters and treatment modalities of malignant melanoma patients with brain metastases. Methods. Experimental design: a retrospective study with a mean follow-up of 46 months. Setting: specialized Cancer Center. Patients: the charts of 136 patients, treated in Roswell Park Cancer Institute, for melanoma brain metastases, were analyzed. Interventions: all patients were treated surgically and in the majority adjuvant therapy was applied. Measures: survival and time of recurrence of patients and possible prognostic factors. Results. Patients who were treated surgically had a better one-year survival rate (28.3%), than patients who received radiotherapy and/or chemotherapy (6.67%) or patients who refused any kind of treatment (3.45%), (p=0.006). Prolonged survival after surgical treatment was found in patients with single metastatic lesions and in patients with multiple metastatic lesions. Conclusions. Melanoma patients with single metastatic lesions to the brain seem to do better after surgical treatment. The role of surgical intervention in patients with multiple brain metastases needs re-evaluation from a big multicenter, prospective trial.