Background: The lung is the second most common site for metastatic malignant melanoma, with a poor prognosis. In this regard, identify clinicopathological predictors for Melanoma Lung Metastases (MLM) plays a pivotal role in clinical practice. Methods: We computer-searched the clinical records of all our patients registered in our melanoma database to identify patients that presented MLM. Kaplan-Meier product was used to estimate time to MELANOMA LUNG METASTASES (TMLM) and Overall Survival (OS); while the log-rank test was used to evaluate differences between the survival curves. Cox proportional hazards regression was performed in the analysis between clinicopathological features of the primary tumor and MLM. Results: A total of 63 patients with MLM were included in our analysis. Median TMLM was 27.4 months, while median OS was 55.5 months, with a Median Lung Metastases Survival (MLMS) of 10 months. Melanoma patients with a primary axial tumor (p<0.001) and with an age ≤ 60 years (p=0.01) showed a better TMLM. While OS was statistically significant higher only in axial melanomas (p<0.001), multivariate analysis showed that peripheral site of the primary tumor remained the main predictor to develop MLM, with a significant influence in TMLM and also in the long-term (p<0.01 and p=0.04). Conclusions: Currently no standardized therapies exist for MLM. In this regard, the prevention of secondary recurrences plays a pivotal role in the management of melanoma patients. According to our results, peripheral melanoma is the main predictor for development of MLM
