Temporal muscle thickness is an independent prognostic marker in melanoma patients with newly diagnosed brain metastases

J Neurooncol. 2018 Oct;140(1):173-178. doi: 10.1007/s11060-018-2948-8. Epub 2018 Jul 14.

Abstract

Objectives: The purpose of this study was to evaluate the prognostic relevance of temporal muscle thickness (TMT) in melanoma patients with newly diagnosed brain metastases.

Methods: TMT was retrospectively assessed in 146 melanoma patients with newly diagnosed brain metastases on cranial magnetic resonance images. Chart review was used to retrieve clinical parameters, including disease-specific graded prognostic assessment (DS-GPA) and survival times.

Results: Patients with a TMT > median showed a statistically significant increase in survival time (13 months) compared to patients with a TMT < median (5 months; p < 0.001; log rank test). A Cox regression model revealed that the risk of death was increased by 27.9% with every millimeter reduction in TMT. In the multivariate analysis, TMT (HR 0.724; 95% 0.642-0.816; < 0.001) and DS-GPA (HR 1.214; 95% CI 1.023-1.439; p = 0.026) showed a statistically significant correlation with overall survival.

Conclusion: TMT is an independent predictor of survival in melanoma patients with brain metastases. This parameter may aid in patient selection for clinical trials or to the choice of different treatment options based on the determination of frail patient populations.

Keywords: Brain; Melanoma; Neoplasm metastasis; Prognosis; Sarcopenia.

MeSH terms

  • Adolescent
  • Adult
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / secondary*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / diagnostic imaging
  • Melanoma / pathology*
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Survival Analysis
  • Temporal Muscle / pathology*
  • Tomography Scanners, X-Ray Computed
  • Young Adult