Loss of Local Tumor Control After Index Surgery for Spinal Metastases: A Prospective Cohort Study

Depreitere, Bart; Ricciardi, Federico; Arts, Mark P.; Balabaud, L.; Buchowski, Jacob M.; Bünger, Cody; Chung, Chun Kee; Coppes, Maarten H.; Fehlings, Michael G.; Kawahara, Norio; Lee, Chong Suh; Leung, Yuk‐Man; Martín-Benlloch, Juan Antonio; Massicotte, Eric M.; Mazel, Christian; Meyer, Bernhard; Öner, F. Cumhur; Peul, Wilco C.; Quraishi, Nasir A.; Tokuhashi, Yasuaki; Tomita, Katsuro; Ulbricht, Christian; Verlaan, Jorrit Jan; Wang, Michael; Crockard, H. A.; Choi, David

doi:10.1016/j.wneu.2018.04.170

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…In addition, the series which studied redo surgeries for SpM recurrence found a high recurrence rate of PC SpM, whatever the type of surgery (simple decompression, debulking, fixation) 34 …”

Section: Discussionmentioning

confidence: 98%

“…ECOG/WHO and Karnofsky statuses are pertinent markers of SpM evolution, general cancer progression, and have already been described as predictive factors of survival in patients with SpM, regardless of the primary tumor 31,32 . Previously, preoperative neurological status was identified as a survival prognosis factor according to primary cancer 33–35 . The impact of preoperative neurological status (Frankel score) on predicting survival is contradictory.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Previously, preoperative neurological status was identified as a survival prognosis factor according to primary cancer. [33][34][35] The impact of preoperative neurological status (Frankel score) on predicting survival is contradictory. Of the seven scoring systems reviewed by Crnalic et al 11 only two included it as a prognostic factor for PC.…”

Section: Primary Pc In the Prognostic Scoring System For Spmmentioning

confidence: 99%

“…For example, Roser et al, 46 In addition, the series which studied redo surgeries for SpM recurrence found a high recurrence rate of PC SpM, whatever the type of surgery (simple decompression, debulking, fixation). 34 Subsequent changes in medical management are likely to be responsible for the improvement of survival over recent years concerning PC and metastasis.…”

Section: Surgery For Pc Spmmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Primary Pc In the Prognostic Scoring System For Spmmentioning

confidence: 99%

Section: Surgery For Pc Spmmentioning

confidence: 99%

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Spine metastasis in patients with prostate cancer: Survival prognosis assessment

et al. 2020

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“…There are a variety of scoring systems for preoperative evaluation of surgical methods for spinal metastases, including the Tomita score [5] and the modi ed Tokuhashi score [6]. The survival time of patients can be comprehensively predicted according to the scoring system.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Cement Augmented Fenestrated Screws in the Surgery With Posterior Approach for Spinal Metastases  

Wang

Zang

et al. 2020

Preprint

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Objective: To investigate the efficacy and safety of cement augmented fenestrated screws in the posterior approach for spinal metastases.Methods: A total of 52 patients with spinal metastases who underwent surgery with posterior approach separation and internal fixation with pedicle screw in the Department of Orthopaedics of the Fourth Hospital of Hebei Medical University from January 2015 to January 2017 were analyzed retrospectively. There were 28 cases in the cement augmented pedicle screw group and 24 cases in the conventional pedicle screw group. The clinical data, preoperative and postoperative pain, and neurological function between the two groups were compared. After follow-up, every 3 months, the local progression-free survival time of patients in the two groups was recorded to explore the safety of cement augmented pedicle screws in posterior separation of spinal metastases, and to analyze the difference in efficacy between the two groups.Results: There were no significant differences in sex, age, segments of the affected vertebra, Tomita score, Tokuhashi score, spinal instability neoplastic score (SINS), intraoperative blood loss and average postoperative hospital stays between the two groups. The average operation time was 161 ± 21 minutes in the cement augmented pedicle screw group and 135 ± 19 minutes in the conventional pedicle screw group, with a statistically significant difference. A total of 218 screws were implanted in the 28 patients of the cement augmented pedicle screw group, with an average of 1.3 ± 0.4 ml of cement injected into each screw. There was 1 case of cerebrospinal fluid leakage in each of the two groups, and no incision hematoma formation or infection occurred. There was no symptomatic pulmonary cement embolism in the cement augmented pedicle screw group. The preoperative VAS scores were not statistically different between the two groups. However, the VAS scores in the two groups decreased 3 months after surgery, which were 2.93 ± 1.33 and 4.17 ± 1.34, respectively, with statistical significance. The recovery of Frankel grading was found in 84.6% of all patients (44 cases in 52 patients), but there was no significant difference in Frankel grades between the two groups before and 3 months after surgery. During the follow-up period of 6-24 months, there were 10 cases of adjacent segmental metastasis (2 cases in cement augmented pedicle screw group and 8 cases in conventional pedicle screw group) and 8 cases of internal fixation failure (1 case cement augmented pedicle screw group and 7 cases in conventional pedicle screw group). The difference was statistically significant. Compared with the conventional pedicle screw group, the conventional pedicle screw group had a longer survival time of progression-free in the local and adjacent segments, and the difference was statistically significant. Conclusion: The application of cement augmented pedicle screw in surgery of spinal metastases with the posterior approach is safe, and the pain score decreases more obviously 3 months after surgery. It can effectively reduce the adjacent segmental metastasis and failure rate of internal fixation and prolong the local progression-free survival time.

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Revision surgery for tumors of the thoracic and lumbar spine: causes, prevention, and treatment strategy

et al. 2020

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Loss of Local Tumor Control After Index Surgery for Spinal Metastases: A Prospective Cohort Study

Cited by 8 publications

References 30 publications

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

Efficacy and Safety of Cement Augmented Fenestrated Screws in the Surgery With Posterior Approach for Spinal Metastases

Revision surgery for tumors of the thoracic and lumbar spine: causes, prevention, and treatment strategy

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Loss of Local Tumor Control After Index Surgery for Spinal Metastases: A Prospective Cohort Study

Cited by 8 publications

References 30 publications

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

Spine metastasis in patients with prostate cancer: Survival prognosis assessment

Efficacy and Safety of Cement Augmented Fenestrated Screws in the Surgery With Posterior Approach for Spinal Metastases&nbsp;&nbsp;

Revision surgery for tumors of the thoracic and lumbar spine: causes, prevention, and treatment strategy

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Efficacy and Safety of Cement Augmented Fenestrated Screws in the Surgery With Posterior Approach for Spinal Metastases