METASTATIC MELANOMA TO THE SPINE - DEMOGRAPHICS, RISK-FACTORS, AND PROGNOSIS IN 114 PATIENTS

Study Design. One-hundred-fourteen patients with metastatic melanoma o f the spine were retrospectively reviewed. Objective. the goal was to define the demographics, risk factors, and prognosis for this populati on. Summary of Background Data. The incidence of melanoma is increasin g faster than any other cancer. Therefore, orthopedic and neurologic s urgeons will be increasingly confronted by patients with spinal metast ases from melanoma. However, the demographics, risk factors, and progn osis remain unclear. Methods. From 7010 consecutive patients with mela noma, 114 were identified with clinically or radiographically evident spinal metastases. A comparison was made between these patients and th e remainder of the population with melanoma seen at our institution us ing contingency table analysis with statistical significance determine d by a chi-squared test. Survival data were represented by Kaplan-Meie r curves, and log-rank testing was used for statistical comparisons. R esults. Risk factors associated with the development of these metastas es included primary lesions that were ulcerated, deeper than 0.76 mm, or of Clark level II, or located on the trunk or mucosal surfaces. The median survival time for all patients was 86 days, but this was reduc ed in patients with more than one metastatic site in addition to the s pine, Conclusion. The prognosis for most patients with spinal metastas es from melanoma is dismal. However, patients with metastatic disease limited to the spine and one other organ may survive for a relatively prolonged time and may be candidates for surgical intervention directe d toward symptomatic relief.