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Journal of Neurosurgical Sciences 2000 December;44(4):211-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

Kostadoulakis M. M. 1, Messaris E. 2, Zografos G. 2, Androulakis G. 2, Karakousis C. 1

1 Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, USA; 2 Laboratory of Surgical Research, 1st Department of Propaedeutic Surgery, University of Athens, Greece


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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.

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