Comprehensive surgical treatment strategy for spinal metastases

Abstract The management of patients with spinal metastases (SM) requires a multidisciplinary team of specialists involved in oncological care. Surgical management has evolved significantly over the recent years, which warrants reevaluation of its role in the oncological treatment concept. Any patien...

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Autores principales:	Arthur Wagner, Elena Haag, Ann-Kathrin Joerger, Philipp Jost, Stephanie E. Combs, Maria Wostrack, Jens Gempt, Bernhard Meyer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1e36b214889a483986d3541bd32a1c92
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spelling	oai:doaj.org-article:1e36b214889a483986d3541bd32a1c922021-12-02T14:30:52ZComprehensive surgical treatment strategy for spinal metastases10.1038/s41598-021-87121-12045-2322https://doaj.org/article/1e36b214889a483986d3541bd32a1c922021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87121-1https://doaj.org/toc/2045-2322Abstract The management of patients with spinal metastases (SM) requires a multidisciplinary team of specialists involved in oncological care. Surgical management has evolved significantly over the recent years, which warrants reevaluation of its role in the oncological treatment concept. Any patient with a SM was screened for study inclusion. We report baseline characteristics, surgical procedures, complication rates, functional status and outcome of a large consecutive cohort undergoing surgical treatment according to an algorithm. 667 patients underwent 989 surgeries with a mean age of 65 years (min/max 20–94) between 2007 and 2018. The primary cancers mostly originated from the prostate (21.7%), breast (15.9%) and lung (10.0%). Surgical treatment consisted of dorsoventral stabilization in 69.5%, decompression without instrumentation in 12.5% and kyphoplasty in 18.0%. Overall survival reached 18.4 months (95% CI 9.8–26.9) and the median KPS increased by 10 within hospital stay. Surgical management of SMs should generally represent the first step of a conclusive treatment algorithm. The need to preserve long-term symptom control and biomechanical stability requires a surgical strategy currently not supported by level I evidence.Arthur WagnerElena HaagAnn-Kathrin JoergerPhilipp JostStephanie E. CombsMaria WostrackJens GemptBernhard MeyerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Arthur Wagner Elena Haag Ann-Kathrin Joerger Philipp Jost Stephanie E. Combs Maria Wostrack Jens Gempt Bernhard Meyer Comprehensive surgical treatment strategy for spinal metastases
description	Abstract The management of patients with spinal metastases (SM) requires a multidisciplinary team of specialists involved in oncological care. Surgical management has evolved significantly over the recent years, which warrants reevaluation of its role in the oncological treatment concept. Any patient with a SM was screened for study inclusion. We report baseline characteristics, surgical procedures, complication rates, functional status and outcome of a large consecutive cohort undergoing surgical treatment according to an algorithm. 667 patients underwent 989 surgeries with a mean age of 65 years (min/max 20–94) between 2007 and 2018. The primary cancers mostly originated from the prostate (21.7%), breast (15.9%) and lung (10.0%). Surgical treatment consisted of dorsoventral stabilization in 69.5%, decompression without instrumentation in 12.5% and kyphoplasty in 18.0%. Overall survival reached 18.4 months (95% CI 9.8–26.9) and the median KPS increased by 10 within hospital stay. Surgical management of SMs should generally represent the first step of a conclusive treatment algorithm. The need to preserve long-term symptom control and biomechanical stability requires a surgical strategy currently not supported by level I evidence.
format	article
author	Arthur Wagner Elena Haag Ann-Kathrin Joerger Philipp Jost Stephanie E. Combs Maria Wostrack Jens Gempt Bernhard Meyer
author_facet	Arthur Wagner Elena Haag Ann-Kathrin Joerger Philipp Jost Stephanie E. Combs Maria Wostrack Jens Gempt Bernhard Meyer
author_sort	Arthur Wagner
title	Comprehensive surgical treatment strategy for spinal metastases
title_short	Comprehensive surgical treatment strategy for spinal metastases
title_full	Comprehensive surgical treatment strategy for spinal metastases
title_fullStr	Comprehensive surgical treatment strategy for spinal metastases
title_full_unstemmed	Comprehensive surgical treatment strategy for spinal metastases
title_sort	comprehensive surgical treatment strategy for spinal metastases
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1e36b214889a483986d3541bd32a1c92
work_keys_str_mv	AT arthurwagner comprehensivesurgicaltreatmentstrategyforspinalmetastases AT elenahaag comprehensivesurgicaltreatmentstrategyforspinalmetastases AT annkathrinjoerger comprehensivesurgicaltreatmentstrategyforspinalmetastases AT philippjost comprehensivesurgicaltreatmentstrategyforspinalmetastases AT stephanieecombs comprehensivesurgicaltreatmentstrategyforspinalmetastases AT mariawostrack comprehensivesurgicaltreatmentstrategyforspinalmetastases AT jensgempt comprehensivesurgicaltreatmentstrategyforspinalmetastases AT bernhardmeyer comprehensivesurgicaltreatmentstrategyforspinalmetastases
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Comprehensive surgical treatment strategy for spinal metastases

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