Ori Barzilai1, Anne L Versteeg2, Arjun Sahgal3, Laurence D Rhines4, Mark H Bilsky1,5, Daniel M Sciubba6, James M Schuster7, Michael H Weber8, Peter Pal Varga9, Stefano Boriani10, Chetan Bettegowda6, Michael G Fehlings11, Yoshiya Yamada12, Michelle J Clarke13, Paul M Arnold14, Ziya L Gokaslan15, Charles G Fisher16, Ilya Laufer1,5. 1. Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York. 2. Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Ontario, Canada. 4. Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Neurological Surgery, Weill Cornell Medical College, New York, New York. 6. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. 7. Department of Neurosurgery, Hospital, University of Pennsylvania, Philadelphia, Pennsylvania. 8. Division of Surgery, McGill University, Montreal General Hospital, Montreal, Quebec, Canada. 9. National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary. 10. GSpine4 Spine Surgery Division, IRCCS Galeazzi Orthopedic Institute, Milan, Italy. 11. Division of Neurosurgery and Spine Program, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada. 12. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York. 13. Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota. 14. Department of Neurosurgery, The University of Kansas Hospital, Kansas City, Kansas. 15. Department of Neurosurgery, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, The Miriam Hospital, Brown University, Providence, Rhode Island. 16. Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: The treatment of oligometastatic (≤5 metastases) spinal disease has trended toward ablative therapies, yet to the authors' knowledge little is known regarding the prognosis of patients presenting with oligometastatic spinal disease and the value of this approach. The objective of the current study was to compare the survival and clinical outcomes of patients with cancer with oligometastatic spinal disease with those of patients with polymetastatic (>5 metastases) disease. METHODS: The current study was an international, multicenter, prospective study. Patients who were admitted to a participating spine center with a diagnosis of spinal metastases and who underwent surgical intervention and/or radiotherapy between August 2013 and May 2017 were included. Data collected included demographics, overall survival, local control, and treatment information including surgical, radiotherapy, and systemic therapy details. Health-related quality of life (HRQOL) measures included the EuroQOL 5 dimensions 3-level questionnaire (EQ-5D-3L), the 36-Item Short Form Health Survey (SF-36v2), and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ). RESULTS: Of the 393 patients included in the current study, 215 presented with oligometastatic disease and 178 presented with polymetastatic disease. A significant survival advantage of 90.1% versus 77.3% at 3 months and 77.0% versus 65.1% at 6 months from the time of treatment was found for patients presenting with oligometastatic disease compared with those with polymetastatic disease. It is important to note that both groups experienced significant improvements in multiple HRQOL measures at 6 months after treatment, with no differences in these outcome measures noted between the 2 groups. CONCLUSIONS: The treatment of oligometastatic disease appears to offer a significant survival advantage compared with polymetastatic disease, regardless of treatment choice. HRQOL measures were found to improve in both groups, demonstrating a palliative benefit for all treated patients.
BACKGROUND: The treatment of oligometastatic (≤5 metastases) spinal disease has trended toward ablative therapies, yet to the authors' knowledge little is known regarding the prognosis of patients presenting with oligometastatic spinal disease and the value of this approach. The objective of the current study was to compare the survival and clinical outcomes of patients with cancer with oligometastatic spinal disease with those of patients with polymetastatic (>5 metastases) disease. METHODS: The current study was an international, multicenter, prospective study. Patients who were admitted to a participating spine center with a diagnosis of spinal metastases and who underwent surgical intervention and/or radiotherapy between August 2013 and May 2017 were included. Data collected included demographics, overall survival, local control, and treatment information including surgical, radiotherapy, and systemic therapy details. Health-related quality of life (HRQOL) measures included the EuroQOL 5 dimensions 3-level questionnaire (EQ-5D-3L), the 36-Item Short Form Health Survey (SF-36v2), and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ). RESULTS: Of the 393 patients included in the current study, 215 presented with oligometastatic disease and 178 presented with polymetastatic disease. A significant survival advantage of 90.1% versus 77.3% at 3 months and 77.0% versus 65.1% at 6 months from the time of treatment was found for patients presenting with oligometastatic disease compared with those with polymetastatic disease. It is important to note that both groups experienced significant improvements in multiple HRQOL measures at 6 months after treatment, with no differences in these outcome measures noted between the 2 groups. CONCLUSIONS: The treatment of oligometastatic disease appears to offer a significant survival advantage compared with polymetastatic disease, regardless of treatment choice. HRQOL measures were found to improve in both groups, demonstrating a palliative benefit for all treated patients.
Authors: Xin Shelley Wang; Laurence D Rhines; Almon S Shiu; James N Yang; Ugur Selek; Ibrahima Gning; Ping Liu; Pamela K Allen; Syed S Azeem; Paul D Brown; Hadley J Sharp; David C Weksberg; Charles S Cleeland; Eric L Chang Journal: Lancet Oncol Date: 2012-01-27 Impact factor: 41.316
Authors: Carmine Zoccali; Jesse Skoch; Christina M Walter; Mohammad Torabi; Mark Borgstrom; Ali A Baaj Journal: Eur Spine J Date: 2015-12-01 Impact factor: 3.134
Authors: Charles G Fisher; Christian P DiPaola; Timothy C Ryken; Mark H Bilsky; Christopher I Shaffrey; Sigurd H Berven; James S Harrop; Michael G Fehlings; Stefano Boriani; Dean Chou; Meic H Schmidt; David W Polly; Roberto Biagini; Shane Burch; Mark B Dekutoski; Aruna Ganju; Peter C Gerszten; Ziya L Gokaslan; Michael W Groff; Norbert J Liebsch; Ehud Mendel; Scott H Okuno; Shreyaskumar Patel; Laurence D Rhines; Peter S Rose; Daniel M Sciubba; Narayan Sundaresan; Katsuro Tomita; Peter P Varga; Luiz R Vialle; Frank D Vrionis; Yoshiya Yamada; Daryl R Fourney Journal: Spine (Phila Pa 1976) Date: 2010-10-15 Impact factor: 3.468
Authors: Michael T Milano; Alan W Katz; Ann G Muhs; Abraham Philip; Daniel J Buchholz; Michael C Schell; Paul Okunieff Journal: Cancer Date: 2008-02-01 Impact factor: 6.860
Authors: Ori Barzilai; Stefano Boriani; Charles G Fisher; Arjun Sahgal; Jorrit Jan Verlaan; Ziya L Gokaslan; Aron Lazary; Chetan Bettegowda; Laurence D Rhines; Ilya Laufer Journal: Global Spine J Date: 2019-05-08
Authors: Frederic Bludau; Laura Winter; Grit Welzel; Udo Obertacke; Frank Schneider; Frederik Wenz; Arne Mathias Ruder; Frank A Giordano Journal: Radiat Oncol Date: 2020-11-12 Impact factor: 3.481
Authors: Giuseppe Roberto Giammalva; Gianluca Ferini; Fabio Torregrossa; Lara Brunasso; Sofia Musso; Umberto Emanuele Benigno; Rosa Maria Gerardi; Lapo Bonosi; Roberta Costanzo; Federica Paolini; Paolo Palmisciano; Giuseppe Emmanuele Umana; Rina Di Bonaventura; Carmelo Lucio Sturiale; Domenico Gerardo Iacopino; Rosario Maugeri Journal: Life (Basel) Date: 2022-04-12