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

Introduction: 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. Research question: 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. Methods: 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). Results: 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). Discussion and conclusion: 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.