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. 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.