<p>Clinical Characteristics and Prognostic Analysis of Gynecologic Cancer with Spinal Metastases: A Single-Center Retrospective Study</p>

Abstract

Objective The purpose of this study is to provide key information on the clinical characteristics, surgical treatment, and potential prognostic factors in patients with metastatic spinal gynecologic cancer (MSGC), with a view to their application in clinical practice. Methods From January 2010 to January 2020, we performed a retrospective analysis of 14 patients with MSGC who underwent surgical treatment in a single center. Surgical treatment was performed on 14 patients, and a total of 14 operations were performed. The survival time of patients after spinal surgery was analyzed by Kaplan–Meier and Cox regression analysis. Results The average age of patients was 51.9 years (range 25‒70). The average time from initial surgery to the discovery of spinal metastasis was 60.3 months (2‒180), and the average follow-up time was 19.2 months (2‒55). Spinal tumor progression was found in 9 patients, and 12 patients (85.7%) died during follow-up. In univariate analysis, extraosseous visceral metastasis (p = 0.024), revised Tokuhashi stage (p = 0.025), Tomita stage (p = 0.005), and number of spinal lesions (p = 0.038) were associated with overall survival (OS). Extraosseous visceral metastasis (p = 0.026), revised Tokuhashi stage (p = 0.014), Tomita stage (p = 0.001), and gynecological cancer type (p = 0.039) were associated with progression-free survival. Conclusion Surgical treatment is an effective treatment for MSGC and relieves pain, restores function and rebuilds stability. Based on our single-center experience, extraosseous visceral metastasis, revised Tokuhashi stage, Tomita stage, and gynecological cancer type may be potential prognostic factors for OS.

Clinical Characteristics, Treatment Modalities, and Potential Contributing and Prognostic Factors in Patients with Bone Metastases from Gynecological Cancers: A Systematic Review

“…The longest median overall survival time found in this review was 45 months; however, most studies indicate a median overall survival of ~12 months. In agreement with the literature, our review revealed that GC bone metastases most affected the axial skeleton and in particular the vertebral column [ 13 ]. The causes of this trend are not yet fully understood, but it has been hypothesized that the cellular and molecular characteristics of cancer cells and the tissues to which they metastasize are critical and affect the pattern of metastatic spread; however contradictory or inconclusive results have been reported [ 14 , 55 ].…”

“…Bone metastases from GCs were detected in about 1.1–5.2% of patients with CC [ 8 ], in ~1.2% of patients with OC [ 9 ], in 2–8% of patients with EC [ 10 ], and rarely in vulvar (VuC) [ 11 ] and vaginal cancers (VaC) [ 12 ]. Despite the uncommon incidence of GC bone metastases, the prolonged local disease control and the easy availability of advanced imaging techniques are increasing this incidence, and more and more anecdotal evidence is reported in the literature [ 8 , 13 , 14 ]. Not unexpectedly, these complications seriously affect quality of life, performance status, independent functioning, and survival.…”

The risk of distant metastases in patients with gynecologic cancers after surgery: a population-based study

“…Gynecologic cancers may occur to women of all ages worldwide; the diseases often result in disruptions in physical and mental health, quality of life, and even early death [ 21 , 22 ]. Some patients develop metastases after treatment even though with the strategies of standardized treatments of tumors in recent years [ 23 ].…”