Metastatic spine tumor epidemiology: comparison of trends in surgery across two decades and three continents.

Metastatic spine tumor epidemiology: comparison of trends in surgery across two decades and three continents.

World Neurosurg. 2018 Mar 20;:

Authors: Wright E, Ricciardi F, Arts M, Buchowski JM, Chung CK, Coppes M, Crockard A, Depreitere B, Fehlings M, Kawahara N, Lee CS, Leung Y, Martin-Benlloch A, Massicotte E, Mazel C, Oner C, Peul W, Quraishi N, Tokuhashi Y, Tomita K, Ulbricht C, Verlaan JJ, Wang M, Choi D

Abstract
BACKGROUND: Indications for surgery for symptomatic spinal metastases have been better defined in recent years, and suitable outcome measures established, against a changing back-drop of patient characteristics, tumor behavior and oncological treatments. However variations still exist in the local management of patients with spinal metastases. The objective was to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and how this has changed over the last 25 years.
METHODS: A cohort study of consecutive patients undergoing surgery for symptomatic spinal metastases. Data was collected using a secure internet database, in 22 centers across 3 continents. All patients were invited to take part in the study, unless 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% (standard error 0.013) at 1 year, 31% (standard error 0.013) at 2 years, and 10% (standard error 0.013) at 5 years after surgery. Survival improved over successive time-periods, with longer survival in patients who received surgery in 2011-2016 compared to earlier time-periods.
CONCLUSION: Surgical habits have been fairly consistent between countries around the world, and over time. However, patient survival has improved in later years, which is perhaps due to medical advances in the treatment of cancer, improved patient selection, or operating earlier in the course of the disease.

PMID: 29572177 [PubMed - as supplied by publisher]

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