Surgical intervention for vertebral metastases may benefit lung cancer patients no less than other patients: a retrospective study

Abstract

BackgroundSpinal metastasis is considered to have a worse prognosis in lung cancer than in other cancers, but recent clinical studies report improved overall survival of lung cancer. We compared the postoperative prognoses of vertebral metastatic tumors from lung with other types of cancer.MethodsFrom 2011 to 2015, 31 Japanese patients (mean age 73 years, range 55–88 years; 19 males, 12 females) underwent surgery for spinal metastasis at our center. We observed patients retrospectively in March 2016, dividing them into groups by cancer type: lung (LK group, n = 10); prostate, breast, or thyroid (PB group, n = 12); and other (OT group, n = 9). We compared survival and revised Tokuhashi score, which provides a basis for choosing a treatment course. Neurologic status was graded before and after surgery using the Frankel system.ResultsMean follow-up was 16.5 months (range 1–62 months). Only seven of 31 patients (22.6%) were alive at final follow-up. Frankel grade significantly improved postoperatively only in the LK (P = 0.01) and PB (P = 0.048) groups. Revised Tokuhashi score differed across groups (P < 0.0001), and was significantly lower in the LK group than in the PB group (P = 0.00) and OT group (P = 0.02). Postoperative survival was significantly shorter in the LK group than in the PB group (P = 0.01) but did not differ between the LK and OT groups.ConclusionsThe revised Tokuhashi score may underestimate the survival of lung cancer patients, who may derive the same benefit from surgical intervention as those with vertebral metastasis from other cancer types.

Sigmoid volvulus in an adolescent female: A case report

“…Etiology of sigmoid volvulus is a redundant loop of sigmoid that twists on its mesenteric pedicle more than 180 0 causing luminal obstruction and mesenteric blood flow obstruction resulting in intestinal obstruction and can progress to hemorrhagic perforation, peritonitis, septic shock and even death [1] , [8] .…”

“…Sigmoid volvulus is a rare cause of pediatric and adolescent bowel obstruction [1] . It accounts for 2% to 5% of colonic volvulus in adult type [2] .…”

“…Clinical presentations are unspecific and diagnosis relies on high clinical suspicion. Sigmoid volvulus presents acutely with abdominal pain, distention and vomiting and often the chronic form is insidious with vague signs and symptoms at diagnosis [1] . We present a 16-year-old adolescent female with sigmoid volvulus.…”

Current Status of the Use of Salvaged Blood in Metastatic Spine Tumour Surgery

“…The most common sites for metastasis are the lung and liver, followed by the skeleton [ 3 ]. The spine is the most common site for skeletal metastases [ 4 - 6 ], with almost 70% of cancer patients developing spinal metastases; 10% of these patients present with cord compression [ 5 ].…”

“…Surgery is currently the mainstay of treatment for metastatic spine disease, when a patient’s life expectancy is more than 3 months [ 4 , 6 , 7 ]. Metastatic spine tumour surgery (MSTS) is indicated in patients experiencing intractable pain, diminished neurological status, or at risk for impending cord compression due to spinal instability [ 4 ].…”