Background: Patients with melanoma frequently develop central nervous system metastases. Oligometastatic disease is often treatedeither by surgical resection or by stereotactic radiotherapy. This studyinvestigates the trends and clinical outcomes of patients with melanomawho have undergone surgical procedures on the central nervoussystem during their hospitalization.Methods: A retrospective study was performed based on admissionsof adult patients who underwent craniotomy for metastatic melanomafrom 2000 to 2014 using the Nationwide Inpatient Sample database.The primary outcome measure was all-cause in-hospital mortality. Secondaryoutcomes included hospital length of stay (LOS) and dischargedisposition (home/home with health care and skilled nursing facilities/long-term acute care (SNFs/LTAC)). Factors associated with in-hospitalmortality were examined by multivariable logistic regression. Weadjusted for patient and hospital characteristics, payer, and comorbidconditions. We also examined trends of mortality for the study years.Results: There were an estimated 1,216 discharges of patients withmelanoma undergoing craniotomy during the study period. Patients undergoingsurgical interventions were typically males (69%) and whites(79%). Ninety-eight percent of procedures were performed at teachinghospitals. Unadjusted all-cause in-hospital mortality was 3.1%. Therewas no significant difference in mortality over 13 years. Age, gender,and race were not associated with increased in-hospital mortality. LOSwas longer in elderly and those with higher Charlson ComorbidityIndex. Of the survivors, 76% were discharged to home or with homehealthcare while 24% were discharged to SNFs/LTAC. Patients withage > 65 (odds ratio (OR): 2.9; 95% confidence interval (CI): 2.2 - 3.9,P < 0.001) and those with higher Charlson Comorbidity Index (OR: 1.2;95% CI: 1.1 - 1.3) had higher odds for being discharged to SNFs/LTAC. Conclusions: Patients who undergo craniotomy for metastatic melanomahave a low in-hospital mortality rate.
ASJC Scopus subject areas
- Cancer Research