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The 3 articles reviewed in this issue of Cancer add to and update previously reported experience regarding the prognosis of melanoma patients diagnosed with brain metastases, but do not answer the important question of identifying which patients diagnosed with early melanoma will go on to develop this complication that most frequently determines the outcome in metastatic melanoma and how and when to best intervene therapeutically. If clinicians wish to use retrospective databases to help improve outcomes for these patients, then better biologic discriminators, based on careful clinico-pathologic correlational observations, need to be incorporated and then validated in large datasets to define useful prognostic subsets.