Overall survival following treatment of central nervous system meningeal melanocytomas: Insights from the national cancer database (NCDB)

TL;DR

This study analyzed survival outcomes for patients with central nervous system melanocytomas and found no significant survival benefit from surgery or radiotherapy.

Contribution

The study provides survival data for CNS melanocytomas using a national database and highlights the lack of impact from treatment modalities.

Findings

The 1- and 5-year overall survival rates for CNS melanocytomas were approximately 80% and 50%, respectively.

Neither gross total resection nor adjuvant radiotherapy significantly affected overall survival.

The rarity and heterogeneity of these tumors suggest a need for prospective and molecular-based studies.

Abstract

Central nervous system (CNS) melanocytomas are rare, pigmented tumors derived from leptomeningeal melanocytes. Although generally benign, they can exhibit locally aggressive behavior and recur. Despite increasing recognition, data on their clinical outcomes and optimal management remain limited.

This study aimed to evaluate the survival outcomes of patients with CNS melanocytomas, using a large national registry, and to explore the prognostic relevance of tumor location and treatment modalities.

We queried the National Cancer Database (NCDB) for cases of CNS melanocytomas diagnosed between 2004 and 2017. Patient demographics, tumor characteristics, treatment details, and survival outcomes were collected. Kaplan-Meier survival analysis was used to study overall survival (OS).

A total of 143 patients with CNS melanocytomas were identified, including 58 spinal (40.6 %), 49 intracranial (34.3 %), 36 tumors of unspecified location (25.2 %). The median age at diagnosis was 59 years, with males comprising 48.3 % of the cohort. Gross total resection (GTR) was reported in 28 patients (19.6 %), while adjuvant radiotherapy was performed in 51 patients (35.7 %). The 1- and 5-year OS rates were approximately 80 % and 50 %, respectively. There were no significant differences in OS based on sex, age, tumor location, extent of resection, or use of adjuvant radiotherapy (p ≥ 0.05).

Despite advances in surgical techniques and radiation therapy, the optimal management of CNS melanocytomas remains an area of ongoing investigation. Since our findings failed to demonstrate a survival benefit from GTR or the use of adjuvant radiotherapy, future prospective studies should focus on refining treatment indications.

•CNS melanocytomas show a 1- and 5-year OS of ∼80 % and ∼50 % respectively, with no differences based on tumor location, age, or sex.•Neither extent of resection nor adjuvant radiotherapy significantly impacted overall survival.•Findings underscore the rarity and heterogeneity of CNS melanocytomas, emphasizing the role of prospective and molecular-based studies.

CNS melanocytomas show a 1- and 5-year OS of ∼80 % and ∼50 % respectively, with no differences based on tumor location, age, or sex.

Neither extent of resection nor adjuvant radiotherapy significantly impacted overall survival.

Findings underscore the rarity and heterogeneity of CNS melanocytomas, emphasizing the role of prospective and molecular-based studies.

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