Abstract

The authors retrospectively studied 31 patients with malignant melanoma who were surgically treated for 34 skeletal metastases between 1987 and 2007. The aim was to evaluate the role of orthopaedic surgery and to identify factors related to survival. The patients were operated on for spinal cord compression (n = 12) and metastatic destruction in a long bone (n = 17), or other locations (n = 5). The median survival after surgery was 1.9 months (range: 0-40). The survival rate was 039 at 3 months, and 0.13 at 1 year. Four of 34 operations led to failure necessitating reoperation. A prolonged delay between diagnosis and surgery, radical excision, a solitary skeletal metastasis, radiotherapy, a perioperative lactate dehydrogenase (LDH) level < or = 8 microkat/L (p = 0.04) and a preoperative haemoglobin level > 11.5 mg/dL (p = 0.003) had a favourable prognostic impact. A vertebral localization was unfavourable. These prognostic factors may help identify which melanoma patients with symptomatic skeletal metastases will benefit from orthopaedic surgery. This study represents the largest reported cohort surgically treated for skeletal metastasis of malignant melanoma at a single institution.

Authors

Wedin R, Falkenius J, Weiss RJ, Hansson J

Institution

Dept of Orthopaedics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. rikard.wedin@karolinska.se

Source

Acta orthopaedica Belgica 78:2 2012 Apr pg 246-53

MeSH

Adult
Aged
Bone Neoplasms
Female
Humans
L-Lactate Dehydrogenase
Male
Melanoma
Middle Aged
Prognosis
Skin Neoplasms
Spinal Cord Compression
Survival Analysis
Young Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22696997