黑色素瘤软脑膜病（LMD）预后较差。然而，晚期黑色素瘤患者的治疗方法随着时间的推移而不断发展，包括 LMD 患者。我们回顾了一大群黑色素瘤 LMD 患者，以评估与生存相关的因素。收集了 2015 年至 2020 年在 MD 安德森癌症中心诊断为 LMD 的患者的回顾性临床数据。总生存期 (OS) 是从 LMD 诊断到死亡日期确定的或最后一次跟进。 Kaplan-Meier 方法和对数秩检验分别用于估计 OS 和评估单变量组差异。使用 Cox 比例风险回归模型确定生存与感兴趣变量的多变量关联。总共确定了 172 名患者。 LMD 诊断时的中位年龄为 53 岁（范围 20-79），所有患者的大脑或脊柱磁共振成像都有 LMD 的放射学证据。总共 143 名患者之前接受过全身治疗 (83%)，之前接受过治疗的中位数为 2 次（范围 0-5）。 81 名患者 (47%) 患有并发不受控制的全身性疾病，80 名患者 (53%) 在诊断时血清 LDH 升高。中位随访时间为 4.0 个月（范围 0.1-65.3 个月），所有 LMD 诊断患者的中位 OS 为 4.9 个月。接受 LMD 鞘内治疗或全身免疫治疗的患者 (n = 45) 的中位 OS 分别为 8.0 个月和 10.2 个月。多变量分析表明，体能状态下降、脑脊液细胞学阳性、LDH 升高和全脑放射与 OS 较差相关。尽管治疗方案取得了许多进展，但患有 LMD 的黑色素瘤患者的预后仍然很差。然而，一部分患者似乎从 LMD 定向治疗中获益。© 作者 2024。由牛津大学出版社代表神经肿瘤学会和欧洲神经肿瘤学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限均可通过我们网站文章页面上的“权限”链接通过我们的 RightsLink 服务获得 - 欲了解更多信息，请联系journals.permissions@oup.com。

Melanoma leptomeningeal disease (LMD) has a poor prognosis. However, the management of patients with advanced melanoma has evolved with time, including those with LMD. We reviewed a large cohort of melanoma LMD patients to assess factors associated with survival.Retrospective clinical data was collected on patients diagnosed with LMD at MD Anderson Cancer Center from 2015 to 2020. Overall survival (OS) was determined from LMD diagnosis to date of death or last follow-up. The Kaplan-Meier method and log-rank test were used to estimate OS and to assess univariate group differences, respectively. Multivariable associations of survival with variables of interest were determined using Cox proportional hazards regression models.A total of 172 patients were identified. The median age at LMD diagnosis was 53 (range 20-79) years, and all patients had radiographic evidence of LMD on magnetic resonance imaging of either brain or spine. In total 143 patients previously received systemic therapy (83%), with a median of 2 prior treatments (range 0-5). 81 patients (47%) had concurrent uncontrolled systemic disease and 80 patients (53%) had elevated serum LDH at the time of diagnosis. With a median follow-up of 4.0 months (range 0.1-65.3 months), median OS for all patients from LMD diagnosis was 4.9 months. Patients (n = 45) who received intrathecal therapy or systemic immunotherapy for LMD had a median OS of 8.0 months and 10.2 months, respectively. On multivariable analysis, decreased performance status, positive CSF cytology, elevated LDH, and whole brain radiation were associated with worse OS.Despite many advances in therapeutic options, the outcomes of melanoma patients with LMD remains poor. However, a subset of patients appears to derive benefit from LMD-directed treatment.© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.