Avaliação da sobrevida e caracterização clinico-patológica de pacientes com melanoma metastático para o sistema nervoso central

Abstract

Brain metastases from melanoma are frequent and are associated with a poor prognosis. They are associated with 60-70% of deaths in patients with melanoma. It is estimated that approximately one third of patients with newly diagnosed metastatic melanoma have synchronous radial metastases. This retrospective cohort study includes patients treated at Hospital São Lucas da PUCRS, from 2007 to 2017 and aims to evaluate survival and describe the clinicopathological characteristics of these patients.. All patients treated at the oncology service with a diagnosis of metastatic melanoma were included. Of the total number of patients with melanoma treated at the HSL-PUCRS oncology outpatient clinic, 67 (12.3%) had brain metastases. Most patients were male (67.2%) and more than half were white (50.7%). At the first evaluation, 63.6% of the patients were younger than 60 years, most had no family history of melanoma (44.8%). When we observed the pathological characteristics of the patients included, patients with lymph node involvement predominated, totaling 44.9%, the presence of ulceration was observed in 64.3% of the cases, the peripheral margin was negative in 85.7% of the cases, the absence of microsatellites was observed in 76.2% of the cases, 49.3% of the patients had a Clark level 4 or 5. About 1/3 of the patients had nodular melanoma and the most frequent primary site was the back, making up 28.4% of the cases. In the study population, a median survival of 75.9 months was estimated, which is higher than that observed in the literature and which can be explained by the profile of the patients analyzed.