Abstract
Background: Metastatic melanoma disease is accompanied by highly systemic inflammatory responses. The prognostic value of preoperative laboratory inflammation markers in brain metastatic melanoma patients has not been adequately investigated so far. Methods: Preoperative inflammatory blood parameters were correlated to overall survival (OS) rates in melanoma patients that underwent surgery for brain metastasis (BM) between 2013 and 2019 at the authors’ institution. Receiver operating characteristic (ROC) analyses were used for cutoff determination of routine laboratory parameters. Results: Median OS in the present cohort of 30 melanoma patients with surgically treated BM was 7 months (95% confidence interval (CI) 5.7–8.3). Initial elevated C-reactive protein (CRP) levels (>10 mg/L), neutrophil-to-lymphocyte ratio (NLR) ≥ 4, platelet-to-lymphocyte ratio (PLR) ≥ 145, and lymphocyte-to-monocyte ratio (LMR) < 2 were associated with significantly reduced OS rates. Conclusions: The present study identifies several preoperative peripheral inflammatory markers as indicators for poor prognosis in melanoma patients with BM undergoing neurosurgical treatment. Elevated initial CRP values, higher NLR and PLR, and lower LMR were associated with reduced OS and, thus, might be incorporated into preoperative interdisciplinary treatment planning and counseling for affected patients.
Highlights
The incidence of brain metastases (BMs) is increasing and patients have to face very poor life expectancy [1]
After BM resection was recommended by the institutional interdisciplinary tumor board, surgical resection of the BM was performed in all patients analyzed
In the case of multiple brain metastases, the interdisciplinary tumor board had previously decided on the indication for resection of multiple or single lesions
Summary
The incidence of brain metastases (BMs) is increasing and patients have to face very poor life expectancy [1]. Immunotherapy has provided crucial advances in the treatment of advanced melanoma [3,4,5,6,7] Essential in this regard has been a focus on and increasing interest in the inflammatory host response to neoplasms. The systemic response that might be initiated by this process has been attempted to be demonstrated in numerous association studies using a wide variety of laboratory parameters in peripheral blood as potential prognostic indicators in a variety of solid tumors [9,10,11,12,13,14]. Methods: Preoperative inflammatory blood parameters were correlated to overall survival (OS) rates in melanoma patients that underwent surgery for brain metastasis (BM) between 2013 and 2019 at the authors’ institution. Initial elevated C-reactive protein (CRP) levels (>10 mg/L), neutrophil-to-lymphocyte ratio (NLR) ≥ 4, platelet-to-lymphocyte ratio (PLR) ≥ 145, and lymphocyte-to-monocyte ratio (LMR) < 2 were associated with significantly reduced
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