NYMC Faculty Publications

Epidemiology, Management, and Treatment Outcomes of Metastatic Spinal Melanoma

David X. Zheng, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Sauson Soldozy, Department of Neurological Surgery, University of Miami, Miami, FL, United States.
Kathleen M. Mulligan, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Melissa A. Levoska, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Erin F. Cohn, Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, United States.
Ariel Finberg, Department of Neurological Surgery, University of Miami, Miami, FL, United States.
Peter Alsaloum, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Thomas B. Cwalina, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Simon J. Hanft, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY, United States.
Jeffrey F. Scott, Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Luke D. Rothermel, Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Vinod E. Nambudiri, Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.

Author Type(s)

Faculty

Journal Title

World Neurosurgery: X

First Page

100156

Document Type

Article

Publication Date

4-1-2023

Department

Neurosurgery

Abstract

Metastatic spinal melanoma is a rare and aggressive disease process with poor prognosis. We review the literature on metastatic spinal melanoma, focusing on its epidemiology, management, and treatment outcomes. Demographics of metastatic spinal melanoma are similar to those for cutaneous melanoma, and cutaneous primary tumors tend to be most common. Decompressive surgical intervention and radiotherapy have traditionally been considered mainstays of treatment, and stereotactic radiosurgery has emerged as a promising approach in the operative management of metastatic spinal melanoma. While survival outcomes for metastatic spinal melanoma remain poor, they have improved in recent years with the advent of immune checkpoint inhibition, used in conjunction with surgery and radiotherapy. New treatment options remain under investigation, especially for patients with disease refractory to immunotherapy. We additionally explore several of these promising future directions. Nevertheless, further investigation of treatment outcomes, ideally incorporating high-quality prospective data from randomized controlled trials, is needed to identify optimal management of metastatic spinal melanoma.

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