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Int. J. Mol. Sci. 2016, 17(3), 400; doi:10.3390/ijms17030400

Retrospective Study of Metastatic Melanoma and Renal Cell Carcinoma to the Brain with Multivariate Analysis of Prognostic Pre-Treatment Clinical Factors

1
Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA
2
Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA
3
University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
4
Inland Neurosurgery & Spine Associates, 105 W 8th Ave, Suite 200, Spokane, WA 99204, USA
5
Rockwood Clinic, 801 W. 5th Ave, Suite 525, Spokane, WA 99204, USA
6
DataWorks Northwest, LLC, 3952 N Magnuson St, Coeur D’Alene, ID 83815, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Kurt A. Jellinger
Received: 31 December 2015 / Revised: 27 February 2016 / Accepted: 8 March 2016 / Published: 18 March 2016
(This article belongs to the Special Issue Brain Metastasis 2016)
View Full-Text   |   Download PDF [701 KB, uploaded 18 March 2016]   |  

Abstract

Patients with brain metastasis from renal cell carcinoma (RCC) or melanoma have historically had very poor prognoses of less than one year. Stereotactic radiosurgery (SRS) can be an effective treatment for patients with these tumors. This study analyzes the effect of pretreatment prognostic factors on overall survival (OS) for RCC and melanoma patients with metastasis to the brain treated with SRS. A total of 122 patients with brain metastases from either RCC or melanoma were grouped by age at brain metastasis diagnosis, whether they received whole brain radiation therapy (WBRT) in addition to SRS, or they underwent surgical resection, Karnofsky Performance Score (KPS), number of brain metastases, and primary tumor. Median survival times for melanoma patients and RCC patients were 8.20 ± 3.06 and 12.70 ± 2.63 months, respectively. Patients with >5 metastases had a significantly shorter median survival time (6.60 ± 2.45 months) than the reference group (1 metastasis, 10.70 ± 13.40 months, p = 0.024). Patients with KPS ≤ 60 experienced significantly shorter survival than the reference group (KPS = 90–100), with median survival times of 5.80 ± 2.46 months (p < 0.001) and 45.20 ± 43.52 months, respectively. We found a median overall survival time of 12.7 and 8.2 months for RCC and melanoma, respectively. Our study determined that a higher number of brain metastases (>5) and lower KPS were statistically significant predictors of a lower OS prognosis. View Full-Text
Keywords: melanoma; renal cell carcinoma; brain metastasis; stereotactic radiosurgery; prognostic factors melanoma; renal cell carcinoma; brain metastasis; stereotactic radiosurgery; prognostic factors
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Ferrel, E.A.; Roehrig, A.T.; Kaya, E.A.; Carlson, J.D.; Ling, B.C.; Wagner, A.; MacKay, A.R.; Call, J.A.; Demakas, J.J.; Lamoreaux, W.T.; Fairbanks, R.K.; Cooke, B.S.; Peressini, B.; Lee, C.M. Retrospective Study of Metastatic Melanoma and Renal Cell Carcinoma to the Brain with Multivariate Analysis of Prognostic Pre-Treatment Clinical Factors. Int. J. Mol. Sci. 2016, 17, 400.

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