Surgical management of cerebral metastases from melanoma: outcome in 147 patients treated at a single institution over two decades

Object. The aim of this study was to review the outcome of patients who underwent surgery for treatment of cerebral metastatic melanoma. Methods. A retrospective analysis was performed in 147 patients with cerebral metastases from melanoma who were treated surgically at a single institution between 1979 and 1999. Almost all patients underwent postoperative whole-brain radiation therapy. The mean patient age was 53 years (range 17–76 years); 69% of patients were male. A single cerebral metastasis was identified in 84% of patients, although 56% had synchronous extracranial metastases. The 30-day postoperative mortality rate was 2% and neurological symptoms resolved or improved in 78% of patients. Recurrence of intracerebral disease was seen in 55% of patients and 26% died of intracerebral metastases. Twenty-four patients underwent reoperation for recurrent cerebral disease. The median survival duration from the time of surgery for all patients was 8.5 months; the 3- and 5-year survival rates were 9% and 5%,...