Contemporary spinal oncology treatment paradigms and outcomes for metastatic tumors to the spine: A systematic review of breast, prostate, renal, and lung metastases

Yao, Amy; Sarkiss, Christopher A.; Ladner, Travis R.; Jenkins, Arthur L.

doi:10.1016/j.jocn.2017.04.004

Cited by 54 publications

(34 citation statements)

References 55 publications

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“…In order to relieve pain, improve nerve function, control local tumors, and improve quality of life for patients, surgery is more and more widely performed, including minimally invasive surgery, palliative surgery, or radical surgery. In turn, the majority of studies report a significant clinical effect for carefully selected spinal metastatic patients. Flavio Tancioni et al .…”

Section: Introductionmentioning

confidence: 99%

Patient Characteristics Following Surgery for Spinal Metastases: A Multicenter Retrospective Study

Yang

Wang

Zhang

et al. 2019

Orthopaedic Surgery

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ObjectivesTo summarize the epidemiological characteristics of patients following surgery for spinal metastases retrospectively and make a univariate analysis to identify independent variables that could affect the operation decision making.MethodsThis was a multicenter retrospective review of patients with spinal metastasis who were treated with surgery from 1 January 2007 to 31 July 2019. Basic clinical data were analyzed retrospectively by univariate analysis to identify independent variables that could affect the decision of operation modalities, including gender, age, spinal metastatic site, Frankel score, Karnofsky performance score (KPS), spinal instability neoplastic score (SINS), visual analogue scale (VAS), Tokuhashi score, urinary and fecal incontinence, spinal pathological fracture, primary tumor, extraspinal metastasis, visceral metastasis, and bone lesion (osteolytic, osteoblastic or mixed).ResultsA total of 580 patients including 332 males and 248 females were enrolled in the study with an average age of 58.26 years old (range, 13–86 years old). The most common spinal metastatic level was the thoracic vertebra (190 [32.76%]), followed by the lumbar vertebra (146 [25.17%]), cervical vertebra (47 [8.10%]), and sacral vertebra (35 [6.03%]). Metastases involving more than two sites of the cervical, thoracic, lumbar, and sacral vertebrae arose in 162 (27.93%) patients. For primary tumor, there were 198 (34.14%) cases of lung cancer, 41 (7.07%) cases of kidney cancer, 39 (6.72%) cases of breast cancer, 38 (6.55%) cases of gastrointestinal cancer, 35 (6.03%) cases of lymphoma and myeloma, 25 (4.31%) cases of prostate cancer, 24 (4.14%) cases of liver cancer, 23 (3.97%) cases of mesenchymal tissue sarcoma, 20 (3.45%) cases of thyroid cancer, and 84 (14.48%) cases were tumor with unknown origin. Sixty‐three (10.86%) patients received minimally invasive surgery, 460 (79.31%) patients received palliative surgery, and the remaining 57 (9.83%) received tumor resection. According to the univariate analysis, the KPS score, SINS score, VAS score, Tokuhashi score, urinary and fecal incontinence, spinal pathological fracture, and bone lesion (osteolytic, osteoblastic or mixed) were independent and favorable factors affecting the surgery modalities.ConclusionsSurgical treatment for spinal metastases was mainly to relieve pain, rebuild spinal stability, improve nerve function, control local tumors, and improve the quality of life of patients. For middle‐aged and elderly patients with good general conditions, severe pain, spinal pathological fracture, spine instability and without urinary and fecal incontinence, early surgical treatment should be actively carried out.

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Section: Introductionmentioning

confidence: 99%

Patient Characteristics Following Surgery for Spinal Metastases: A Multicenter Retrospective Study

Yang

Wang

Zhang

et al. 2019

Orthopaedic Surgery

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“…function, control the growth of tumor, improve the quality of life of patients, provide conditions for patients to receive other treatments such as radiotherapy, chemotherapy, and immunotherapy, and even extend the survival [24]. The latest clinical research showed that relatively positive surgical resection and reasonable timing and method of surgery directly affect the quality of life and survival of cancer patients [25,26]. In the current study, a total of 705 patients (31.64%) underwent surgical treatments, including 154 patients (21.84%) who underwent minimally invasive surgeries, 441 patients (62.55%) who underwent palliative surgeries, and 110 patients (15.60%) who underwent radical surgeries.…”

Section: Spinal Involvementmentioning

confidence: 99%

A multicenter, descriptive epidemiologic survey of the clinical features of spinal metastatic disease in China

Zhang

Qiao

Yang

et al. 2020

Neurological Research

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Background: Spinal metastases have unique epidemiological features and treatment methods. Unfortunately, the relative scarcity of spinal metastases has limited the widespread development of descriptive epidemiological studies, especially in Asian countries. The purpose of this study was to describe the epidemiological characteristics of patients with metastatic spinal tumors in China between 2007 and 2019. Methods: From January 2007 and July 2019, data on patients with spinal metastases were collected from five cancer centers in China, and demographic characteristics, primary tumor types, segments and numbers of vertebral lesions, disease-related scores, and treatment methods were reviewed. Results: A total of 2228 patients with spinal metastases were reviewed in this study, including 1279 male patients and 949 female patients, and the male to female ratio was 1.35: 1. More than half of patients developed metastatic diseases between the ages of 50 years and 69 years (64%). Overall, lung cancer (824 cases, 37%) was the most common primary tumor type and the most common level of spinal involvement was multi-level of metastases (860 cases, 39%). 705 patients (32%) had undergone surgical treatments, 1028 patients (46%) had undergone radiotherapy for metastatic vertebrae, and 855 patients (38%) had received systemic treatments. The age, primary tumor type, number of involved vertebrae, Frankel grade, and spinal instability neoplastic score would affect the surgical decision-making. Conclusions: This study provides insight into the epidemiological characteristics of spinal metastasis and health care service utilization in spinal metastasis patients in China. Background With the continuous advancement of diagnostic technology and the prolonged survival of cancer patients, the incidence of spinal metastases in the population is increasing. The spine is the third most common site for distant metastases, behind the lungs and liver [1-3]. Overall, spinal metastases occur in 40%-70% of patients with malignant tumors, and 10%-20% of these patients will experience metastatic spinal cord compression, which is mainly manifested by severe spinal pain, impaired neurological function, and even accelerated process of dying [4-6].

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“…The Kaplan-Meier method was used to estimate the metastasis-free survival (MFS). For descriptive and inferential analyses, boot-strapping with replacement (iterations = 1000) was performed to attain variance estimates at a 95% CI: [21].…”

Section: Frankel Scorementioning

confidence: 99%

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

et al. 2020

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Background: Patients presenting spine metastasis (SpM) from prostate cancer (PC) form a heterogeneous population, through this study, we aimed to clarify and update their prognostic assessment. Methods: The patient data used in this study was obtained from a French national multicenter database of patients treated for PC with SpM between 2014 and 2017. A total of 72 patients and 365 SpM cases were diagnosed. Results: The median overall survival time for all patients following the event of SpM was 28.8 months. First, we identified three significant survival prognostic factors of PC patients with SpM: good Eastern Cooperative Oncology Group/World Health Organization personnel status (Status 0 hazard ratio [HR]: 0.031, 95% confidence interval [CI]: 0.008-0.127; p < .0001) or (Status 1 HR: 0.163, 95% CI: 0.068-0.393; p < .0001) and SpM radiotherapy (HR: 2.923, 95% CI: 1.059-8.069; p < .0001). Secondly, the presence of osteolytic lesions of the spine (vs. osteoblastic) was found to represent an independent prognosis factor for longer survival [HR: 0.424, 95% CI: 0.216-0.830; p = .01]. Other factors including the number of SpM, surgery, extraspinal metastasis, synchrone metastasis, metastasis-free survival, and SpM recurrence were not identified as being prognostically relevant to the survival of patients with PC. Conclusion: Survival and our ability to estimate it in patients presenting PC with SpM have improved significantly. Therefore, we advocate the relevance of updating SpM prognostic scoring algorithms by incorporating data regarding the timeline of PC as well as the presence of osteolytic SpM to conceive treatments that are adapted to each patient.

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Contemporary spinal oncology treatment paradigms and outcomes for metastatic tumors to the spine: A systematic review of breast, prostate, renal, and lung metastases

Cited by 54 publications

References 55 publications

Patient Characteristics Following Surgery for Spinal Metastases: A Multicenter Retrospective Study

Patient Characteristics Following Surgery for Spinal Metastases: A Multicenter Retrospective Study

A multicenter, descriptive epidemiologic survey of the clinical features of spinal metastatic disease in China

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

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