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Background <p>Peritumoral brain edema (PTBE) is a major contributor to neurological morbidity in patients with melanoma brain metastases (BM). While serum lactate dehydrogenase (LDH) is an established systemic biomarker in metastatic melanoma, its relationship with local radiological characteristics such as PTBE remains insufficiently understood. This study aimed to investigate the association between serum LDH levels and PTBE, as well as its relationship with clinical and tumor-related parameters.</p> Methods <p>We performed a retrospective analysis of 56 consecutive patients who underwent surgical resection for melanoma BM between 2012 and 2024. Preoperative MRI was used to assess the presence and volumetric extent of PTBE. Clinical, radiological, and laboratory parameters, including serum LDH levels, MIB-1 proliferation index, tumor volume and preoperative seizures were analyzed. Associations were evaluated using univariate analyses and Spearman rank correlation. Receiver operating characteristic (ROC) curve analyses were performed to assess the discriminative ability of the variables.</p> Results <p>Preoperative PTBE was present in 71.4% of patients. Serum LDH levels were significantly higher in patients with PTBE (<i>p</i> &lt; 0.001) and demonstrated a strong positive correlation with edema volume (<i>r</i> = 0.822, <i>p</i> &lt; 0.001). In addition, LDH levels were significantly correlated with the MIB-1 proliferation index (<i>r</i> = 0.601, <i>p</i> &lt; 0.001) and tumor volume (<i>r</i> = 0.584, <i>p</i> &lt; 0.001) and were significantly elevated in patients presenting with preoperative seizures (<i>p</i> &lt; 0.001). ROC analysis demonstrated that LDH had the highest discriminative performance (AUC 0.802, <i>p</i> &lt; 0.001), with an optimal cut-off value of 179.4 U/L.</p> Conclusions <p>In this exploratory study, serum LDH was associated with both the presence and extent of PTBE and may serve as a surrogate of tumor-related biological activity. These hypothesis-generating findings warrant prospective validation before clinical implications can be drawn.</p> Graphical Abstract <p></p>

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Serum lactate dehydrogenase is associated with the presence and extent of preoperative peritumoral edema in melanoma brain metastases

  • 期刊论文

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  • 发表日期：

    2026年7月6日

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  • Alim Emre Basaran,
  • Luca Fahsold,
  • Martin Vychopen,
  • Alonso Barrantes-Freer,
  • Wolf C. Müller,
  • Jan C. Simon,
  • Mirjana Ziemer,
  • Erdem Güresir,
  • Johannes Wach

摘要

Background

Peritumoral brain edema (PTBE) is a major contributor to neurological morbidity in patients with melanoma brain metastases (BM). While serum lactate dehydrogenase (LDH) is an established systemic biomarker in metastatic melanoma, its relationship with local radiological characteristics such as PTBE remains insufficiently understood. This study aimed to investigate the association between serum LDH levels and PTBE, as well as its relationship with clinical and tumor-related parameters.

Methods

We performed a retrospective analysis of 56 consecutive patients who underwent surgical resection for melanoma BM between 2012 and 2024. Preoperative MRI was used to assess the presence and volumetric extent of PTBE. Clinical, radiological, and laboratory parameters, including serum LDH levels, MIB-1 proliferation index, tumor volume and preoperative seizures were analyzed. Associations were evaluated using univariate analyses and Spearman rank correlation. Receiver operating characteristic (ROC) curve analyses were performed to assess the discriminative ability of the variables.

Results

Preoperative PTBE was present in 71.4% of patients. Serum LDH levels were significantly higher in patients with PTBE (p < 0.001) and demonstrated a strong positive correlation with edema volume (r = 0.822, p < 0.001). In addition, LDH levels were significantly correlated with the MIB-1 proliferation index (r = 0.601, p < 0.001) and tumor volume (r = 0.584, p < 0.001) and were significantly elevated in patients presenting with preoperative seizures (p < 0.001). ROC analysis demonstrated that LDH had the highest discriminative performance (AUC 0.802, p < 0.001), with an optimal cut-off value of 179.4 U/L.

Conclusions

In this exploratory study, serum LDH was associated with both the presence and extent of PTBE and may serve as a surrogate of tumor-related biological activity. These hypothesis-generating findings warrant prospective validation before clinical implications can be drawn.

Graphical Abstract