C Rory Goodwin1, Vijay Yanamadala2, Alejandro Ruiz-Valls1, Nancy Abu-Bonsrah1, Ganesh Shankar2, Eric W Sankey1, Christine Boone1, Michelle J Clarke3, Mark Bilsky4, Ilya Laufer4, Charles Fisher5, John H Shin2, Daniel M Sciubba6. 1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 2. Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA. 3. Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. 4. Department of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. 5. Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada. 6. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: dsciubb1@jhmi.edu.
Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) frequently metastasizes to the spine. The impact of medical and/or surgical intervention on overall survival has been examined in a limited number of clinical studies, and herein we systematically review these data. METHODS: We performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles that reported survival, clinical outcomes, and/or prognostic factors associated with patients diagnosed with spinal metastases. The methodologic quality of each review was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool. RESULTS: There were 26 articles (152 patients) that met the inclusion criteria and were treated with either surgery, radiotherapy, chemotherapy, and/or observation. There were 3 retrospective cohort studies, 17 case reports, 5 case series, and 1 longitudinal observational study. Of the patients with known overall survival after diagnosis of spinal metastasis, survival at 3 months, 6 months, 1 year, 2 years, and 5 years was 95.2%, 83.0%, 28.6%, 2.0%, and 1.4%, respectively. The median survival after diagnosis of the metastasis was 0.7 months in the patients who received no treatment, 7 months in the patients treated with surgical intervention alone, 6 months for patients who received chemotherapy and/or radiation, and 13.5 months in the patients treated with a combination of surgery and medical management. All other clinical or prognostic parameters were of low or insufficient strength. CONCLUSIONS: Patients diagnosed with HCC spinal metastasis have a 10.6-month overall survival. Further analysis of patients in prospective controlled trials will be essential to the development of treatment algorithms for these patients in the future.
BACKGROUND:Hepatocellular carcinoma (HCC) frequently metastasizes to the spine. The impact of medical and/or surgical intervention on overall survival has been examined in a limited number of clinical studies, and herein we systematically review these data. METHODS: We performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles that reported survival, clinical outcomes, and/or prognostic factors associated with patients diagnosed with spinal metastases. The methodologic quality of each review was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool. RESULTS: There were 26 articles (152 patients) that met the inclusion criteria and were treated with either surgery, radiotherapy, chemotherapy, and/or observation. There were 3 retrospective cohort studies, 17 case reports, 5 case series, and 1 longitudinal observational study. Of the patients with known overall survival after diagnosis of spinal metastasis, survival at 3 months, 6 months, 1 year, 2 years, and 5 years was 95.2%, 83.0%, 28.6%, 2.0%, and 1.4%, respectively. The median survival after diagnosis of the metastasis was 0.7 months in the patients who received no treatment, 7 months in the patients treated with surgical intervention alone, 6 months for patients who received chemotherapy and/or radiation, and 13.5 months in the patients treated with a combination of surgery and medical management. All other clinical or prognostic parameters were of low or insufficient strength. CONCLUSIONS:Patients diagnosed with HCC spinal metastasis have a 10.6-month overall survival. Further analysis of patients in prospective controlled trials will be essential to the development of treatment algorithms for these patients in the future.
Authors: Dirk Rades; Theo Veninga; Lukas J A Stalpers; Rainer Schulte; Peter J Hoskin; Philip Poortmans; Steven E Schild; Volker Rudat Journal: Int J Radiat Oncol Biol Phys Date: 2005-09-28 Impact factor: 7.038
Authors: Giuseppe Cabibbo; Marcello Maida; Chiara Genco; Pietro Parisi; Marco Peralta; Michela Antonucci; Giuseppe Brancatelli; Calogero Cammà; Antonio Craxì; Vito Di Marco Journal: World J Hepatol Date: 2012-09-27