Clinical outcomes and prognostic factors following the surgical resection of renal cell carcinoma spinal metastases

Abstract

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Surgical Metastasectomy in the Spine: A Review Article

“…Several studies report the clinical outcomes of SBRT for spinal diseases from radiation‐resistant kidney cancer, indicating a local control rate of 83%–94% after 1 year and 57%–87% after 3 or 4 years [91–95]. The current study of SM for kidney cancer spinal metastases reports a local control rate of 94% after the mean postoperative follow‐up of >6 years and no local recurrence >2 years after surgery [35]. SBRT has a lower rate of complications, including the vertebral fracture rate following the treatment of 4.2%–34.4% [85, 96, 97].…”

“…Osseous metastases from these two tumors have the following common characteristics: (a) they most commonly affect the spine [23, 24, 65]; (b) they present as destructive osteolytic lesions [23, 24, 65]; (c) they are more intractable to systemic and radiation treatments than metastases from other primary cancers [23, 24, 65]; and (d) based on the current guidelines for isolated skeletal metastatic lesions, including in the spine, complete SM with removal of the entire tumor is recommended, if feasible [22, 66, 67]. Excellent clinical results were reported after complete SM for these metastases [34, 35, 68].…”

“…Table 1 summarizes the clinical outcomes from five published articles about complete SM for spinal lesions from single primary malignancies. Although the data may suffer from selection bias inherent to the retrospective nature of the studies, the postoperative survival data are favorable with acceptable local recurrence rates on long‐term follow‐up [34–36, 68, 73]. The completeness of resection is a major factor associated with durable postoperative survival.…”

“…Complete SM is considered an important prognostic factor for these patients with bone metastases [74–76]. Several studies reported that the patients with coexistence of controlled lung metastases had a favorable outcome with spinal SM [35, 36, 68].…”

“…The TES procedure has been popular among spine surgeons treating spinal tumors. Improvements in surgical techniques and preoperative embolization achieve favorable outcomes with low morbidity [30–32], and TES has been performed for solitary and resectable spinal metastases [33–36]. Cogent evidence showing the efficacy of pulmonary SM has now been established [15].…”