Prognostic Value of Preoperative Inflammatory Markers in Melanoma Patients with Brain Metastases

• Main Authors: Matthias Schneider, Niklas Schäfer, Christian Bode, Valeri Borger, Lars Eichhorn, Frank A. Giordano, Erdem Güresir, Muriel Heimann, Yon-Dschun Ko, Felix Lehmann, Anna-Laura Potthoff, Alexander Radbruch, Christina Schaub, Katjana S. Schwab, Johannes Weller, Hartmut Vatter, Ulrich Herrlinger, Jennifer Landsberg, Patrick Schuss
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: Journal of Clinical Medicine
• Subjects: melanoma; brain metastasis; inflammation; surgical resection; overall survival
• Online Access: https://www.mdpi.com/2077-0383/10/4/634

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.