BMET-04LEPTOMENINGEAL CARCINOMATOSIS IN MELANOMA

Abstract

Leptomeningeal carcinomatosis (LM) is a rare complication of melanoma that is associated with a poor prognosis. Given limited data in LM in melanoma, we sought to characterize overall survival in patients with primary melanoma who developed LM. We performed a retrospective review at our institution of LM melanoma patients from 1993 to 2014. Inclusion criteria included patients with documented melanoma and LM as diagnosed by cytology or imaging. Median age was 49.5 years (range, 22-79) in 55 patients, 35 male and 20 female. LM was diagnosed by positive cytology in 20 patients (36.4%) or imaging in 52 patients (94.5%). Median survival from diagnosis of LM to death was 9.7 weeks. Additionally, median time from diagnosis of primary melanoma to LM was 27.3 months (range, 0-109) and from stage IV melanoma 7.5 months (range, 0-46). In univariate analysis, serum lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group (ECOG) performance status, and LM treatment (no treatment, radiation, chemotherapy) influenced survival. In multivariate analysis, abnormal LDH (p < 0.035) remained a significant predictor of poor survival, while LM treatment with chemotherapy compared to no treatment conferred a survival advantage (p < 0.019). Treatment with radiation and ECOG performance status were no longer significant. Our data offer the largest series of melanoma patients with diagnosed LM and help to characterize the clinical presentation of this devastating late-stage complication of cancer. More effective treatments for this complication are necessary.