Single brain metastases from melanoma: remarks on a series of 84 patients

Neurosurg Rev. 2012 Apr;35(2):211-7; discussion 217-8. doi: 10.1007/s10143-011-0348-z. Epub 2011 Sep 14.

Abstract

The authors report on 84 patients with single melanoma brain metastasis surgically treated from 1997 to 2007. There were 46 males and 38 females; mean age was 41 years (range 24-58 years). All patients were surgically treated, and 52 of them received postoperative adjuvant therapy consisting of whole-brain radiation therapy (36), radiosurgery (9), or a combination of these two techniques (7). Brain recurrences were observed in 44 cases, of which 9 were local. Of the latter, seven were re-operated while the remaining two were treated by radiosurgery. At 1-year follow-up, the survival rate was 52% (32 patients) whereas only 12 patients (14%) were still alive after 2 years. None of the patients in which removal was subtotal survived for more than 6 months after surgical treatment. Three years after the onset of the brain metastasis, five patients (6%) were still alive. Survival was significantly influenced by treatment with regard to overall survival reported in other series. A review of literature, together with our own series, suggests that radical surgical treatment of the lesion possibly employing the internal no-touch technique has significantly increased survival in our patients (p < 0.05) and that the association of postoperative radiotherapy and re-operation in the event of recurrent metastatic lesions is advisable even though statistical significance was not reached (p > 0.05).

Publication types

  • Review

MeSH terms

  • Adult
  • Brain / surgery
  • Brain Neoplasms / mortality
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Combined Modality Therapy / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / secondary*
  • Melanoma / surgery
  • Middle Aged
  • Radiosurgery
  • Radiotherapy, Adjuvant
  • Skin Neoplasms / surgery*
  • Survival Rate
  • Treatment Outcome
  • Young Adult