Ernest Wright1, Federico Ricciardi2, Mark Arts3, Jacob M Buchowski4, Chun Kee Chung5, Maarten Coppes6, Alan Crockard1, Bart Depreitere7, Michael Fehlings8, Norio Kawahara9, Chong Suh Lee10, Yee Leung11, Antonio Martin-Benlloch12, Eric Massicotte8, Christian Mazel13, Cumhur Oner14, Wilco Peul15, Nasir Quraishi16, Yasuaki Tokuhashi17, Katsuro Tomita18, Christian Ulbricht19, Jorrit-Jan Verlaan14, Mike Wang20, David Choi21. 1. Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom. 2. Department of Statistical Science, University College London, London, United Kingdom. 3. Department of Neurosurgery, Medical Center Haaglanden, Haaglanden, The Netherlands. 4. Departments of Orthopedic and Neurological Surgery, Washington University, St. Louis, Missouri, USA. 5. Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea. 6. Department of Neurosurgery, University Medical Center Groningen, Groningen, The Netherlands. 7. Division of Neurosurgery, University Hospital Leuven, Leuven, Belgium. 8. Division of Neurosurgery and Spinal Program, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. 9. Department of Orthopedic Surgery, Kanazawa Medical University Hospital, Kanazawa, Japan. 10. Spine Center, Samsung Medical Center, Seoul, Republic of Korea. 11. Department of Orthopaedics, Musgrove Park Hospital, Taunton, United Kingdom. 12. Spinal Unit, University Hospital Dr Peset, Valencia, Spain. 13. Department of Orthopedic Surgery, Institut Mutualiste Montsouris, Paris, France. 14. Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 15. Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands. 16. Centre for Spine Studies and Surgery, Queens Medical Centre, Nottingham, United Kingdom. 17. Department of Orthopedic Surgery, Nihon University School of Medicine, Japan. 18. Department of Orthopedic Surgery, Kanazawa University, Kanazawa, Japan. 19. Department of Neurosurgery, Charing Cross Hospital, London, United Kingdom. 20. Department of Neurosurgery, University of Miami Hospital, Miami, Florida, USA. 21. Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom. Electronic address: david.choi@nhs.net.
Abstract
BACKGROUND: Indications for surgery for symptomatic spinal metastases have become better defined in recent years, and suitable outcome measures have been established against a changing backdrop of patient characteristics, tumor behavior, and oncologic treatments. Nonetheless, variations still exist in the local management of patients with spinal metastases. In this study, we aimed to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and to examine how these have changed over the last 25 years. METHODS: In this cohort study of consecutive patients undergoing surgery for symptomatic spinal metastases, data were collected using a secure Internet database from 22 centers across 3 continents. All patients were invited to participate in the study, except those unable or unwilling to give consent. RESULTS: There was a higher incidence of colonic, liver, and lung carcinoma metastases in Asian countries, and more frequent presentation of breast, prostate, melanoma metastases in the West. Trends in surgical technique were broadly similar across the centers. Overall survival rates after surgery were 53% at 1 year, 31% at 2 years, and 10% at 5 years after surgery (standard error 0.013 for all). Survival improved over successive time periods, with longer survival in patients who underwent surgery in 2011-2016 compared with those who underwent surgery in earlier time periods. CONCLUSIONS: Surgical habits have been fairly consistent among countries worldwide and over time. However, patient survival has improved in later years, perhaps due to medical advances in the treatment of cancer, improved patient selection, and operating earlier in the course of disease.
BACKGROUND: Indications for surgery for symptomatic spinal metastases have become better defined in recent years, and suitable outcome measures have been established against a changing backdrop of patient characteristics, tumor behavior, and oncologic treatments. Nonetheless, variations still exist in the local management of patients with spinal metastases. In this study, we aimed to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and to examine how these have changed over the last 25 years. METHODS: In this cohort study of consecutive patients undergoing surgery for symptomatic spinal metastases, data were collected using a secure Internet database from 22 centers across 3 continents. All patients were invited to participate in the study, except those unable or unwilling to give consent. RESULTS: There was a higher incidence of colonic, liver, and lung carcinoma metastases in Asian countries, and more frequent presentation of breast, prostate, melanoma metastases in the West. Trends in surgical technique were broadly similar across the centers. Overall survival rates after surgery were 53% at 1 year, 31% at 2 years, and 10% at 5 years after surgery (standard error 0.013 for all). Survival improved over successive time periods, with longer survival in patients who underwent surgery in 2011-2016 compared with those who underwent surgery in earlier time periods. CONCLUSIONS: Surgical habits have been fairly consistent among countries worldwide and over time. However, patient survival has improved in later years, perhaps due to medical advances in the treatment of cancer, improved patient selection, and operating earlier in the course of disease.
Authors: Julio C Furlan; Jefferson R Wilson; Eric M Massicotte; Arjun Sahgal; Michael G Fehlings Journal: Neuro Oncol Date: 2022-01-05 Impact factor: 13.029
Authors: Anton A Denisov; Nikita S Zaborovsky; Dmitry A Ptashnikov; Dmitry A Mikhailov; Sergey V Masevnin; Oleg A Smekalenkov Journal: Orthop Rev (Pavia) Date: 2021-01-28