In a nutshell
The authors evaluated the factors that could predict development of brain metastasis in melanoma patients.
Some background
In advanced melanoma, cancer often spreads to the brain (brain metastasis). The functional changes in the body that accompany the symptoms of brain metastasis are currently unknown. However, if patients are promptly treated after cancer detection with radiation or surgery, chances of brain trauma (swelling, bleeding) can be minimized. There is no data currently available on the impact of early detection of brain metastasis in melanoma patient survival.
Factors that could predict brain metastasis development in patients with local/regional melanoma (cancer restricted to the original site) need to be well established. This would help determine the appropriate screening methods for brain metastasis.
Methods & findings
The authors aimed to find out the factors that could predict brain metastasis in patients with local/regional melanoma.
The analysis included data on 607 melanoma patients treated for local/regional melanoma who later developed stage IV melanoma (cancer has spread around the body) with or without brain metastasis. 14% originally had stage I melanoma (less than or equal to 1 mm tumor thickness – how far the cancer reached into the skin). 36% had stage II melanoma (between 1 – 2 mm tumor thickness) and 50% had stage III melanoma (2 – 4 mm tumor thickness). 120 patients had brain metastasis. The brain was the only site of skin cancer recurrence in 53% of these patients.
The average age of patients who developed brain metastasis was 55 years compared to 59 years in patients who did not develop brain metastasis. The site of the first lesion did not differ between patients with and patients without brain metastasis. The average tumor thickness for patients with brain metastasis was 3.43 mm compared to 4.53 mm for patients without brain metastasis. No differences were found between the two groups in terms of ulceration (tumor breaking through skin’s surface) and how quickly the cancer cells grew. Reduced tumor thickness and younger age were independently associated with brain metastasis in patients who experienced stage IV melanoma recurrence.
The bottom line
The fine print
The authors noted that the findings from this study may not be adequate in identifying a melanoma patient population with a high risk of developing subsequent brain metastasis.
Published By :
Surgical oncology
Date :
Jun 01, 2014
