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Objective: To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: A cohort study (1998\u20132023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival. Results: Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate \u2265 1 mm2, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival. Conclusion: Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites.<\/jats:p>","DOI":"10.3390\/cancers16122272","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T08:06:06Z","timestamp":1718784366000},"page":"2272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictive and Prognostic Factors in Melanoma Central Nervous System Metastases\u2014A Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Estefania","family":"Serra","sequence":"first","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Abarzua-Araya","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Melanoma and Skin Cancer Unit, Dermatology Department, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8320165, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Arance","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Martin-Huertas","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3452-7607","authenticated-orcid":false,"given":"Francisco","family":"Aya","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Lourdes","family":"Olondo","sequence":"additional","affiliation":[{"name":"Radiology Service, Hospital Clinic of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rizo-Potau","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Malvehy","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"CIBER on Rare Disease, Instituto de Salud Carlos III, 28029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Puig","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"CIBER on Rare Disease, Instituto de Salud Carlos III, 28029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1608-8820","authenticated-orcid":false,"given":"Cristina","family":"Carrera","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"CIBER on Rare Disease, Instituto de Salud Carlos III, 28029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-0522","authenticated-orcid":false,"given":"Sebastian","family":"Podlipnik","sequence":"additional","affiliation":[{"name":"Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ejca.2022.04.018","article-title":"European Consensus-Based Interdisciplinary Guideline for Melanoma. 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