Nicolas Dea1, Raphaële Charest-Morin2, Daniel M Sciubba3, Justin E Bird4, Alexander C Disch5, Addisu Mesfin6, Áron Lazáry7, Charles G Fisher8, Christopher Ames9. 1. Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada. 2. Department of Orthopaedics, Centre Hospitalier Universitaire de Québec, Québec, Québec, Canada. 3. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD. 4. Department of Orthopedic Oncology, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX. 5. Center for Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany. 6. Department of Orthopaedic Surgery, University of Rochester School of Medicine, Rochester, NY. 7. National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary. 8. Department of Orthopaedics, Division of Spine, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada. 9. Department of Neurosurgery, University of California-San Francisco Medical Center, San Francisco, CA.
Abstract
STUDY DESIGN: Systematic literature review. OBJECTIVE: To investigate if evidence-based principles of oncologic resection for primary spinal tumors are correlated with an acceptable morbidity and mortality profile and satisfactory health-related quality of life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: Respecting oncologic principles for primary spinal tumor surgery is correlated with lower recurrence rates. These interventions are, however, often highly morbid. METHODS: A systematic literature review was performed to address the objectives by searching MEDLINE and EBMR databases. Articles that met our inclusion criteria were reviewed. GRADE guidelines were used for recommendation formulation. RESULTS: A total of 25 articles addressing the morbidity and mortality profile of primary spinal tumor surgery were identified. For sacral tumors, complication rates of up to 100% have been reported and complication-related death ranged from 0% to 27%. Mobile spine tumor complication rates varied from 13% to 73.7% and complication-related death ranged from 0% to 7.7%. Seven articles examining HRQOL for this patient population were identified. The limited literature showed comparable patient HRQOL profiles to those with benign conditions such as degenerative disc disease. CONCLUSION: Respecting oncologic principles for primary spinal tumors are correlated with high adverse event rates. We recommend that primary spinal tumor surgeries be performed in experienced centers with multidisciplinary support teams and that prospective adverse event collection be promoted (strong recommendation/very low certainty of the evidence). Oncologic resection of primary tumors of the spine is associated with HRQOL that more closely approximates normative values with increasing duration of follow-up, but decreases with disease recurrence. We recommend primary spinal tumor surgery be performed with a curative intent whenever possible, even at the expense of greater initial morbidity to optimize long-term HRQOL (strong recommendation/very low certainty of the evidence). LEVEL OF EVIDENCE: N/A.
STUDY DESIGN: Systematic literature review. OBJECTIVE: To investigate if evidence-based principles of oncologic resection for primary spinal tumors are correlated with an acceptable morbidity and mortality profile and satisfactory health-related quality of life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: Respecting oncologic principles for primary spinal tumor surgery is correlated with lower recurrence rates. These interventions are, however, often highly morbid. METHODS: A systematic literature review was performed to address the objectives by searching MEDLINE and EBMR databases. Articles that met our inclusion criteria were reviewed. GRADE guidelines were used for recommendation formulation. RESULTS: A total of 25 articles addressing the morbidity and mortality profile of primary spinal tumor surgery were identified. For sacral tumors, complication rates of up to 100% have been reported and complication-related death ranged from 0% to 27%. Mobile spine tumor complication rates varied from 13% to 73.7% and complication-related death ranged from 0% to 7.7%. Seven articles examining HRQOL for this patient population were identified. The limited literature showed comparable patient HRQOL profiles to those with benign conditions such as degenerative disc disease. CONCLUSION: Respecting oncologic principles for primary spinal tumors are correlated with high adverse event rates. We recommend that primary spinal tumor surgeries be performed in experienced centers with multidisciplinary support teams and that prospective adverse event collection be promoted (strong recommendation/very low certainty of the evidence). Oncologic resection of primary tumors of the spine is associated with HRQOL that more closely approximates normative values with increasing duration of follow-up, but decreases with disease recurrence. We recommend primary spinal tumor surgery be performed with a curative intent whenever possible, even at the expense of greater initial morbidity to optimize long-term HRQOL (strong recommendation/very low certainty of the evidence). LEVEL OF EVIDENCE: N/A.
Authors: Francesca Luzzati; Emanuele Maria Giusti; Gennaro Maria Scotto; Giuseppe Perrucchini; Luca Cannavò; Gianluca Castelnuovo; Andrea Colonna Cottini Journal: Support Care Cancer Date: 2019-07-01 Impact factor: 3.603
Authors: Raphaële Charest-Morin; Charles G Fisher; Arjun Sahgal; Stefano Boriani; Ziya L Gokaslan; Aron Lazary; Jeremy Reynolds; Chetan Bettegowda; Laurence D Rhines; Nicolas Dea Journal: Global Spine J Date: 2019-05-08
Authors: Ori Barzilai; Mary-Kate Amato; Lily McLaughlin; Anne S Reiner; Shahiba Q Ogilvie; Eric Lis; Yoshiya Yamada; Mark H Bilsky; Ilya Laufer Journal: Neurooncol Pract Date: 2017-07-22