{"doi":"10.3390/cancers16122272","title":"Predictive and Prognostic Factors in Melanoma Central Nervous System Metastases—A Cohort Study","abstract":"<jats:p>Background: Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer. Objective: To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: A cohort study (1998–2023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival. Results: Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate ≥ 1 mm2, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival. Conclusion: Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites.</jats:p>","journal":"Cancers","year":2024,"id":617270,"datarank":0.26038425117214575,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.018968564307030696,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.018968564307030696,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":3,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1591768,"name":"Álvaro Abarzua-Araya","orcid":null,"position":1,"is_corresponding":false},{"id":1591769,"name":"Ana Arance","orcid":null,"position":2,"is_corresponding":false},{"id":1591770,"name":"Roberto Martin-Huertas","orcid":null,"position":3,"is_corresponding":false},{"id":1591771,"name":"Francisco Aya","orcid":"0000-0002-3452-7607","position":4,"is_corresponding":false},{"id":1591772,"name":"María Lourdes Olondo","orcid":null,"position":5,"is_corresponding":false},{"id":1591773,"name":"Daniel Rizo-Potau","orcid":null,"position":6,"is_corresponding":false},{"id":240403,"name":"Josep Malvehy","orcid":"0000-0002-6998-914X","position":7,"is_corresponding":false},{"id":14427,"name":"Susana Puig","orcid":"0000-0003-1337-9745","position":8,"is_corresponding":false},{"id":369164,"name":"Cristina Carrera","orcid":"0000-0003-1608-8820","position":9,"is_corresponding":false},{"id":620920,"name":"Sebastián Podlipnik","orcid":"0000-0003-4150-0522","position":10,"is_corresponding":false},{"id":1591767,"name":"Estefania Serra","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Predictive and Prognostic Factors in Melanoma Central Nervous System Metastases—A Cohort Study","abstract":"<jats:p>Background: Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer. Objective: To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: A cohort study (1998–2023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival. Results: Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate ≥ 1 mm2, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival. Conclusion: Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites.</jats:p>","is_dataset_classified":null,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38927977","pmcid":null,"openalex_id":"https://openalex.org/W4399807148","authors":[],"funders":[{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"AGAUR 2017_SGR_1134","title":null},{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"GCB15152978SOEN","title":null},{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"LSHC-CT-2006-018702","title":null},{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"HORIZON-MISS-2021-CANCER-02","title":null},{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"18/00419","title":null},{"funder_name":"CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain","grant_id":"22/01467","title":null},{"funder_name":"European Commission","grant_id":"101096667","title":"Novel health care strategies for melanoma in children, adolescents and young adults"}],"total_grants":7,"fwci":0.8628,"citation_percentile":0.73315532,"influential_citations":0,"citation_trend":[{"year":2025,"count":2},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2072-6694/16/12/2272/pdf?version=1718788546","host_type":"journal"},{"url":"https://www.mdpi.com/2072-6694/16/12/2272/pdf?version=1718788546","host_type":"publisher"},{"url":"https://www.mdpi.com/2072-6694/16/12/2272/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/cancers16122272","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38927977","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11201698","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11201698/pdf/cancers-16-02272.pdf","host_type":"repository"},{"url":"http://dx.doi.org/10.3390/cancers16122272","host_type":""},{"url":"https://dx.doi.org/10.3390/cancers16122272","host_type":""},{"url":"https://doi.org/https://doi.org/10.3390/cancers16122272","host_type":""}],"fields_of_study":["Brain Metastases and Treatment","Cutaneous Melanoma Detection and Management","Melanoma and MAPK Pathways","0301 basic medicine","03 medical and health sciences","0302 clinical medicine"],"mesh_terms":[],"keywords":["Medicine","Melanoma","Proportional hazards model","Oncology","Internal medicine","Metastasis","Logistic regression","Cancer","Cohort","Brain metastasis","Multivariate analysis","Disease","Central nervous system","Pathology","Cancer research","Survival analysis","Prognostic factors","Brain metastases","risk factors","Cutaneous Melanoma","Microscopic Satellitosis","610","Article","03 Salud y bienestar","03 Good Health and Well-being"],"sdg_mappings":[{"sdg_number":3,"sdg_label":"3. 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