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Lifetime Incidence of Brain Metastasis in Elderly Patients With Melanoma

By: Andrew Goldstein
Posted: Tuesday, June 11, 2019

Based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results and Medicare claims, Jill S. Barnholtz-Sloan, PhD, of the Department of Population and Quantitative Health Sciences at Case Western Reserve University School of Medicine, and colleagues examined the incidence of synchronous brain metastases and lifetime brain metastases in survivors of melanoma. The researchers said the study results, which were published in Cancer Epidemiology, Biomarkers & Prevention, could influence future screening and surveillance practices.

“With an aging U.S. population, the number of people with brain metastasis is increasing, although sometimes that metastasis does not occur until many years after the initial cancer diagnosis,” said Dr. Barnholtz-Sloan, in a press release from the American Association for Cancer Research (AACR).

The study included data on 21,860 patients with melanoma who were 65 years of age or older. The incidence proportion of synchronous brain metastases in these patients was 1.1%, whereas the incidence proportion for lifetime brain metastases was 3.6%. Of the patients who had distant disease at diagnosis, 30.4% developed later brain metastases, compared with 15.2% of those who had regional and lymph node involvement, 13.2% of whom had lymph node involvement alone, 7.8% of whom had regional tissue involvement, and 2.5% of whom had localized disease alone.

Dr. Ascha and colleagues concluded that these and other population-based estimates could be used to develop a brain metastasis screening policy for elderly survivors of melanoma cancer. “If we can identify brain metastases earlier in their progression, that could allow for earlier treatment and improved outcomes for these patients,” commented coauthor Mustafa S. Ascha, MS, a PhD candidate, also of Case Western, in an AACR press release.

Disclosure: The study authors’ disclosure information may be found at cebp.aacrjournals.org.



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