{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T20:20:36Z","timestamp":1783369236888,"version":"3.54.6"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Halle (Saale)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malignant melanoma ranks among the leading causes of brain metastases (BM). The Graded Prognostic Assessment (GPA) and the melanoma-specific molecular GPA (molGPA) are well-established prognostic tools that help estimate survival and guide therapeutic decisions. This single-center, retrospective clinical study aimed to evaluate prognostic factors for overall survival (OS), intracranial tumor\u00a0control (IC), and intracranial progression-free survival (IPFS), as well as GPA and molGPA within a real-world clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with melanoma-associated BM who underwent radiotherapy (RT) between January 2016 and December 2023 were included. Study endpoints included OS, IC, and IPFS, with OS and IPFS analyzed across the entire cohort (\n                      <jats:italic>n<\/jats:italic>\n                      = 59) and IC was\u00a0evaluated in cases with follow-up imaging (\n                      <jats:italic>n<\/jats:italic>\n                      = 47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median survival of all patients was 6.9 months (IQR 2.2; 23.6). Regarding OS, three predictive factors were significantly associated with the survival probability: a Karnofsky performance status index (KPS) &lt;70 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003), a GPA score of 0\u20131.0 versus 1.5\u20134.0 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and a molGPA score of 0\u20131.0 versus 1.5\u20134.0 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.034). Intracranial progression-free survival was significantly decreased in patients with KPS &lt;70 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01), multiple brain metastases (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036), and GPA scores of 0\u20131.0 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both GPA and molGPA were validated as significant predictors of OS in patients with melanoma-associated BM. However, GPA emerged as the sole score significantly associated with both OS and IPFS, suggesting a potential advantage in its clinical utility. The validation of GPA and molGPA as significant predictors for OS in a real clinical setting support their use in guiding treatment recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12094-025-04118-2","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T14:42:39Z","timestamp":1764772959000},"page":"1815-1824","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of GPA, molGPA and prognostic factors in melanoma brain metastases: a single-center study"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4925-4612","authenticated-orcid":false,"given":"Jens Christian","family":"Philippi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Mittenbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Vordermark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Medenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg Andreas","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"4118_CR1","unstructured":"Ferlay J, E.M., Lam F, Laversanne M, Colombet M, Mery L, Pi\u00f1eros M, Znaor A, Soerjomataram I, Bray F. Global Cancer Observatory: Cancer Today. 2024 [cited 2024 15.10.2024]; Available from: https:\/\/gco.iarc.who.int\/today,."},{"issue":"8","key":"4118_CR2","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1002\/(SICI)1097-0142(19961015)78:8<1781::AID-CNCR19>3.0.CO;2-U","volume":"78","author":"ES Nussbaum","year":"1996","unstructured":"Nussbaum ES, et al. Brain metastases. Histology, multiplicity, surgery, and survival. Cancer. 1996;78(8):1781\u20138.","journal-title":"Cancer"},{"issue":"1","key":"4118_CR3","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1007\/s12032-013-0466-2","volume":"30","author":"U Bottoni","year":"2013","unstructured":"Bottoni U, et al. Predictors and survival in patients with melanoma brain metastases. Med Oncol. 2013;30(1):466. https:\/\/doi.org\/10.1007\/s12032-013-0466-2.","journal-title":"Med Oncol"},{"issue":"1","key":"4118_CR4","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3322\/caac.21763","volume":"73","author":"RL Siegel","year":"2023","unstructured":"Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17\u201348. https:\/\/doi.org\/10.3322\/caac.21763.","journal-title":"CA Cancer J Clin"},{"issue":"8","key":"4118_CR5","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1002\/cncr.25643","volume":"117","author":"J Zakrzewski","year":"2011","unstructured":"Zakrzewski J, et al. Clinical variables and primary tumor characteristics predictive of the development of melanoma brain metastases and post-brain metastases survival. Cancer. 2011;117(8):1711\u201320. https:\/\/doi.org\/10.1002\/cncr.25643.","journal-title":"Cancer"},{"issue":"8","key":"4118_CR6","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1002\/cncr.10426","volume":"94","author":"JC Buchsbaum","year":"2002","unstructured":"Buchsbaum JC, et al. Survival by radiation therapy oncology group recursive partitioning analysis class and treatment modality in patients with brain metastases from malignant melanoma. Cancer. 2002;94(8):2265\u201372. https:\/\/doi.org\/10.1002\/cncr.10426.","journal-title":"Cancer"},{"issue":"7","key":"4118_CR7","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1200\/jco.2004.08.140","volume":"22","author":"KM Fife","year":"2004","unstructured":"Fife KM, et al. Determinants of outcome in melanoma patients with cerebral metastases. J Clin Oncol. 2004;22(7):1293\u2013300. https:\/\/doi.org\/10.1200\/jco.2004.08.140.","journal-title":"J Clin Oncol"},{"issue":"1","key":"4118_CR8","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1007\/s12672-023-00722-2","volume":"14","author":"Q Wu","year":"2023","unstructured":"Wu Q, et al. A modified melanoma-molGPA scoring model: assessment of survival after and efficacy of different radiotherapy modalities in patients with melanoma brain metastases. Discov Oncol. 2023;14(1):116. https:\/\/doi.org\/10.1007\/s12672-023-00722-2.","journal-title":"Discov Oncol"},{"issue":"2","key":"4118_CR9","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1016\/j.ijrobp.2007.06.074","volume":"70","author":"PW Sperduto","year":"2008","unstructured":"Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran W. A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys. 2008;70(2):510\u20134. https:\/\/doi.org\/10.1016\/j.ijrobp.2007.06.074.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"4118_CR10","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.ijrobp.2017.06.2454","volume":"99","author":"PW Sperduto","year":"2017","unstructured":"Sperduto PW, Jiang W, Brown PD, Braunstein S, Sneed P, Wattson DA, et al. Estimating survival in melanoma patients with brain metastases: an update of the graded prognostic assessment for melanoma using molecular markers (Melanoma-molGPA). Int J Radiat Oncol Biol Phys. 2017;99(4):812\u20136. https:\/\/doi.org\/10.1016\/j.ijrobp.2017.06.2454.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"4118_CR11","unstructured":"Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Diagnostik, Therapie und Nachsorge des Melanoms, Langversion 3.3, 2020, AWMF Registernummer: 032\/024OL, http:\/\/www.leitlinienprogramm- onkologie.de\/leitlinien\/melanom\/ (abgerufen am: 05.08.2024)."},{"issue":"12","key":"4118_CR12","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.1093\/annonc\/mdz411","volume":"30","author":"O Michielin","year":"2019","unstructured":"Michielin O, et al. Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up\u2020\u2020approved by the ESMO guidelines committee: February 2002, last update September 2019. Ann Oncol. 2019;30(12):1884\u2013901. https:\/\/doi.org\/10.1093\/annonc\/mdz411.","journal-title":"Ann Oncol"},{"issue":"8","key":"4118_CR13","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1038\/sj.bjc.6605622","volume":"102","author":"M Staudt","year":"2010","unstructured":"Staudt M, et al. Determinants of survival in patients with brain metastases from cutaneous melanoma. Br J Cancer. 2010;102(8):1213\u20138. https:\/\/doi.org\/10.1038\/sj.bjc.6605622.","journal-title":"Br J Cancer"},{"issue":"2","key":"4118_CR14","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1215\/15228517-2007-058","volume":"10","author":"JJ Raizer","year":"2008","unstructured":"Raizer JJ, et al. Brain and leptomeningeal metastases from cutaneous melanoma: survival outcomes based on clinical features. Neuro Oncol. 2008;10(2):199\u2013207. https:\/\/doi.org\/10.1215\/15228517-2007-058.","journal-title":"Neuro Oncol"},{"issue":"5","key":"4118_CR15","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1001\/jamaoncol.2015.1206","volume":"1","author":"S Goyal","year":"2015","unstructured":"Goyal S, et al. Clinical management of multiple melanoma brain metastases: a systematic review. JAMA Oncol. 2015;1(5):668\u201376. https:\/\/doi.org\/10.1001\/jamaoncol.2015.1206.","journal-title":"JAMA Oncol"},{"issue":"1","key":"4118_CR16","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/00008390-200302000-00016","volume":"13","author":"F Mornex","year":"2003","unstructured":"Mornex F, et al. A prospective randomized multicentre phase III trial of fotemustine plus whole brain irradiation versus fotemustine alone in cerebral metastases of malignant melanoma. Melanoma Res. 2003;13(1):97\u2013103. https:\/\/doi.org\/10.1097\/00008390-200302000-00016.","journal-title":"Melanoma Res"},{"issue":"8","key":"4118_CR17","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1002\/cncr.25631","volume":"117","author":"TK Eigentler","year":"2011","unstructured":"Eigentler TK, et al. Number of metastases, serum lactate dehydrogenase level, and type of treatment are prognostic factors in patients with brain metastases of malignant melanoma. Cancer. 2011;117(8):1697\u2013703. https:\/\/doi.org\/10.1002\/cncr.25631.","journal-title":"Cancer"},{"issue":"1","key":"4118_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.hemonc.2021.11.001","volume":"16","author":"A Anvari","year":"2023","unstructured":"Anvari A, Sasanpour P, Kheradmardi MR. Radiotherapy and immunotherapy in melanoma brain metastases. Hematol Oncol Stem Cell Ther. 2023;16(1):1\u201320. https:\/\/doi.org\/10.1016\/j.hemonc.2021.11.001.","journal-title":"Hematol Oncol Stem Cell Ther"},{"issue":"10","key":"4118_CR19","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1007\/s12094-021-02607-8","volume":"23","author":"KA Kessel","year":"2021","unstructured":"Kessel KA, et al. Outcomes after stereotactic radiosurgery of brain metastases in patients with malignant melanoma and validation of the melanoma molGPA. Clin Transl Oncol. 2021;23(10):2020\u20139. https:\/\/doi.org\/10.1007\/s12094-021-02607-8.","journal-title":"Clin Transl Oncol"},{"issue":"8","key":"4118_CR20","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1002\/cncr.25634","volume":"117","author":"MA Davies","year":"2011","unstructured":"Davies MA, et al. Prognostic factors for survival in melanoma patients with brain metastases. Cancer. 2011;117(8):1687\u201396. https:\/\/doi.org\/10.1002\/cncr.25634.","journal-title":"Cancer"},{"issue":"1","key":"4118_CR21","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13014-017-0951-4","volume":"13","author":"H Badakhshi","year":"2018","unstructured":"Badakhshi H, et al. Are prognostic indices for brain metastases of melanoma still valid in the stereotactic era? Radiat Oncol. 2018;13(1):3. https:\/\/doi.org\/10.1186\/s13014-017-0951-4.","journal-title":"Radiat Oncol"},{"issue":"5","key":"4118_CR22","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1016\/s0360-3016(01)02772-9","volume":"52","author":"C Yu","year":"2002","unstructured":"Yu C, Chen JCT, Apuzzo MLJ, O\u2019Day S, Giannotta SL, Weber JS, et al. Metastatic melanoma to the brain: prognostic factors after gamma knife radiosurgery. Int J Radiat Oncol Biol Phys. 2002;52(5):1277\u201387. https:\/\/doi.org\/10.1016\/s0360-3016(01)02772-9.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"4118_CR23","doi-asserted-by":"publisher","first-page":"2439","DOI":"10.3892\/ijo.2015.2970","volume":"46","author":"C Ostheimer","year":"2015","unstructured":"Ostheimer C, Bormann C, Fiedler E, Marsch W, Vordermark D. Malignant melanoma brain metastases: treatment results and prognostic factors--a single-center retrospective study. Int J Oncol. 2015;46(6):2439\u201348. https:\/\/doi.org\/10.3892\/ijo.2015.2970.","journal-title":"Int J Oncol"},{"key":"4118_CR24","doi-asserted-by":"publisher","first-page":"704890","DOI":"10.3389\/fonc.2022.704890","volume":"12","author":"G Liao","year":"2022","unstructured":"Liao G, et al. Impact of previous local treatment for brain metastases on response to molecular targeted therapy in BRAF-mutant melanoma brain metastasis: a systematic review and meta-analysis. Front Oncol. 2022;12:704890. https:\/\/doi.org\/10.3389\/fonc.2022.704890.","journal-title":"Front Oncol"},{"issue":"16","key":"4118_CR25","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1200\/JCO-24-01351","volume":"43","author":"PW Sperduto","year":"2025","unstructured":"Sperduto PW, et al. Improved survival and prognostication in melanoma patients with brain metastases: an update of the melanoma graded prognostic assessment. J Clin Oncol. 2025;43(16):1910\u20139. https:\/\/doi.org\/10.1200\/JCO-24-01351.","journal-title":"J Clin Oncol"}],"container-title":["Clinical and Translational Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12094-025-04118-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12094-025-04118-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12094-025-04118-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T09:52:48Z","timestamp":1776765168000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12094-025-04118-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["4118"],"URL":"https:\/\/doi.org\/10.1007\/s12094-025-04118-2","relation":{},"ISSN":["1699-3055"],"issn-type":[{"value":"1699-3055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"assertion":[{"value":"7 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. Ethical Approval was given by the ethics commission of the Martin Luther University Halle (Wittenberg). We certify that the submission is original work and is not under review at any other publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}