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Cancers
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Bone and Spine Metastases
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Bone and Spine Metastases

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Metastasis".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 4414

Special Issue Editors

Dr. Kenichiro Kakutani

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
Interests: metastasis reconstruction; spine surgery; rehabilitation
Special Issues, Collections and Topics in MDPI journals
Dr. Yutaro Kanda

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Interests: bone metastases; spinal metastases; spine tumor surgery; minimally invasive surgery; intervertebral disc degeneration
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The incidence and prevalence of bone metastases have been rising because cancer-carrying patients have a longer life expectancy owing to recent advances in treatment and diagnosis. Bone metastases can cause pathological fractures, spinal cord compression, and hypercalcemia, leading to serious symptoms including neurological dysfunction and intractable pain. The spine is the most common site of bone metastases, and these symptoms impair the health status and quality of life of patients, the addressal of which is the goal of multidisciplinary treatment for bone and spine metastases. However, there is still room for improvement in the treatment of bone and spine metastases. Further research on surgery, radiotherapy, and systemic treatment, including anti-tumor drugs, molecular targeted drugs, and bone‐modifying agents, is warranted. Additionally, it is extremely valuable to understand the biology of bone metastases and to develop new treatments with fewer and/or less-severe side effects. The goal of this Special Issue is to improve clinical outcomes and propose a new strategy for bone and spine metastases.

You may choose our Joint Special Issue in JCM.

Dr. Kenichiro Kakutani
Dr. Yutaro Kanda
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone metastases
  • spinal metastases
  • stereotactic body radiotherapy
  • conventional radiotherapy
  • spine surgery
  • spondylectomy
  • minimally invasive surgery
  • particle-beam radiotherapy
  • systemic agents
  • microenvironment

Published Papers (5 papers)

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12 pages, 2166 KiB  
Article
Outcomes in Patients with Spinal Metastases Managed with Surgical Intervention
by Brendan Knapp, Ashwin Govindan, Shalin S. Patel, Kymberlie Pepin, Ningying Wu, Siddhartha Devarakonda and Jacob M. Buchowski
Cancers 2024, 16(2), 438; https://doi.org/10.3390/cancers16020438 - 19 Jan 2024
Viewed by 715
Abstract
Background: Spinal metastases are a significant cause of morbidity in patients with advanced cancer, and management often requires surgical intervention. Although prior studies have identified factors that influence outcomes with surgery, the ability of these factors to predict outcomes remains unclear in the [...] Read more.
Background: Spinal metastases are a significant cause of morbidity in patients with advanced cancer, and management often requires surgical intervention. Although prior studies have identified factors that influence outcomes with surgery, the ability of these factors to predict outcomes remains unclear in the era of contemporary therapies, and there is a need to better identify patients who are likely to benefit from surgery. Methods: We performed a single-center, retrospective analysis to evaluate risk factors for poor outcomes in patients with spinal metastases treated with surgery. The primary outcome was mortality at 180 days. Results: A total of 128 patients were identified. Age ≥ 65 years at surgery (p = 0.0316), presence of extraspinal metastases (p = 0.0110), and ECOG performance scores >1 (p = 0.0397) were associated with mortality at 180 days on multivariate analysis. These factors and BMI ≤ 30 mg/kg2 (p = 0.0008) were also associated with worse overall survival. Conclusions: Age > 65, extraspinal metastases, and performance status scores >1 are factors associated with mortality at 180 days in patients with spinal metastases treated with surgery. Patients with these factors and BMI ≤ 30 mg/kg2 had worse overall survival. Our results support multidisciplinary discussions regarding the benefits and risks associated with surgery in patients with these risk factors. Full article
(This article belongs to the Special Issue Bone and Spine Metastases)
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19 pages, 3866 KiB  
Article
A Novel Metastatic Estrogen Receptor-Expressing Breast Cancer Model with Antiestrogen Responsiveness
by Kendall L. Langsten, Lihong Shi, Adam S. Wilson, Salvatore Lumia, Brian Westwood, Alexandra M. Skeen, Maria T. Xie, Victoria E. Surratt, JoLyn Turner, Carl D. Langefeld, Ravi Singh, Katherine L. Cook and Bethany A. Kerr
Cancers 2023, 15(24), 5773; https://doi.org/10.3390/cancers15245773 - 09 Dec 2023
Viewed by 1035
Abstract
Most women diagnosed with breast cancer (BC) have estrogen receptor alpha-positive (ER+) disease. The current mouse models of ER+ BC often rely on exogenous estrogen to encourage metastasis, which modifies the immune system and the function of some tissues like bone. Other studies [...] Read more.
Most women diagnosed with breast cancer (BC) have estrogen receptor alpha-positive (ER+) disease. The current mouse models of ER+ BC often rely on exogenous estrogen to encourage metastasis, which modifies the immune system and the function of some tissues like bone. Other studies use genetically modified or immunocompromised mouse strains, which do not accurately replicate the clinical disease. To create a model of antiestrogen responsive BC with spontaneous metastasis, we developed a mouse model of 4T1.2 triple-negative (TN) breast cancer with virally transduced ER expression that metastasizes spontaneously without exogenous estrogen stimulation and is responsive to antiestrogen drugs. Our mouse model exhibited upregulated ER-responsive genes and multi-organ metastasis without exogenous estrogen administration. Additionally, we developed a second TN BC cell line, E0771/bone, to express ER, and while it expressed ER-responsive genes, it lacked spontaneous metastasis to clinically important tissues. Following antiestrogen treatment (tamoxifen, ICI 182,780, or vehicle control), 4T1.2- and E0771/bone-derived tumor volumes and weights were significantly decreased, exemplifying antiestrogen responsivity in both cell lines. This 4T1.2 tumor model, which expresses the estrogen receptor, metastasizes spontaneously, and responds to antiestrogen treatment, will allow for further investigation into the biology and potential treatment of metastasis. Full article
(This article belongs to the Special Issue Bone and Spine Metastases)
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15 pages, 1800 KiB  
Article
Efficacy of Total En Bloc Spondylectomy versus Stereotactic Ablative Radiotherapy for Single Spinal Metastasis
by Dong-Ho Kang, Wooseok Lee, Bong-Soon Chang, Hyoungmin Kim, Sam Yeol Chang, Seong Hwa Hong, Jin Ho Kim and Hee Jung Son
Cancers 2023, 15(23), 5518; https://doi.org/10.3390/cancers15235518 - 22 Nov 2023
Viewed by 722
Abstract
To compare total en bloc spondylectomy (TES) with stereotactic ablative radiotherapy (SABR) for single spinal metastasis, we undertook a single center retrospective study. We identified patients who had undergone TES or SABR for a single spinal metastasis between 2000 and 2019. Medical records [...] Read more.
To compare total en bloc spondylectomy (TES) with stereotactic ablative radiotherapy (SABR) for single spinal metastasis, we undertook a single center retrospective study. We identified patients who had undergone TES or SABR for a single spinal metastasis between 2000 and 2019. Medical records and images were reviewed for patient and tumor characteristics, and oncologic outcomes. Patients who received TES were matched to those who received SABR to compare local control and survival. A total of 89 patients were identified, of whom 20 and 69 received TES and SABR, respectively. A total of 38 matched patients were analyzed (19 TES and 19 SABR). The median follow-up period was 54.4 (TES) and 26.1 months (SABR) for matched patients. Two-year progression-free survival (PFS) and overall survival (OS) rates were 66.7% and 72.2% in the TES and 38.9% and 50.7% in the SABR group, respectively. At the final follow-up of the matched cohorts, no significant differences were noted in OS (p = 0.554), PFS (p = 0.345) or local progression (p = 0.133). The rate of major complications was higher in the TES than in the SABR group (21.1% vs. 10.5%, p = 0.660). These findings suggest that SABR leads to fewer complications compared to TES, while TES exhibits better mid-term control of metastatic tumors. Full article
(This article belongs to the Special Issue Bone and Spine Metastases)
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18 pages, 2076 KiB  
Systematic Review
The Impact of Adjunct Medical Therapy on Survival after Spine Metastasis: A Systematic Review and Pooled Data Analysis
by Lilly Groszman, Jonathan A. Hubermann, Paul Kooner, Nawaf Alamiri, Anthony Bozzo and Ahmed Aoude
Cancers 2024, 16(7), 1425; https://doi.org/10.3390/cancers16071425 - 07 Apr 2024
Viewed by 619
Abstract
Targeted therapy has greatly improved the outlook for patients with spinal metastatic cancers. Scoring systems like the Tokuhashi or Tomita scores are commonly used to predict prognosis and inform surgical decisions, but they are outdated and fail to consider recent advancements. We aimed [...] Read more.
Targeted therapy has greatly improved the outlook for patients with spinal metastatic cancers. Scoring systems like the Tokuhashi or Tomita scores are commonly used to predict prognosis and inform surgical decisions, but they are outdated and fail to consider recent advancements. We aimed to investigate the current state of the literature and treatment options pertaining to advancements in targeted therapy compared to other forms of medical management for metastatic spinal tumors. This study represents the first comprehensive systematic review that encompasses the most common primary cancers that metastasize to the spine and evaluates the median overall survival (mOS) across five different medical treatment modalities as well as surgical intervention. Additionally, our study analyzes the tumor receptor status in conjunction with these treatments. A PubMed search was conducted, and according to the PRISMA guidelines, 28 articles out of 1834 met the inclusion criteria. The pooled data analysis highlighted the superior efficacy of targeted therapy, evidenced by a significant improvement in the mOS and lower hazard ratios in patients with lung and breast cancers who received targeted therapy compared to those who did not. Our study provides valuable insights into the recent advancements in the medical management of metastatic spinal tumors. Future indications include incorporating this literature into personalized treatment approaches for metastatic spinal tumors. Full article
(This article belongs to the Special Issue Bone and Spine Metastases)
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14 pages, 685 KiB  
Systematic Review
Leiomyogenic Tumor of the Spine: A Systematic Review
by Abdurrahman F. Kharbat, Kishore Balasubramanian, Kiran Sankarappan, Ryan D. Morgan, Khawaja M. Hassan, Paolo Palmisciano, Panayiotis E. Pelargos, Michael Chukwu, Othman Bin Alamer, Ali S. Haider, Tarek Y. El Ahmadieh and John F. Burke
Cancers 2024, 16(4), 748; https://doi.org/10.3390/cancers16040748 - 10 Feb 2024
Viewed by 925
Abstract
The study cohort consisted of 83 patients with a mean age of 49.55 (SD 13.72) with a female preponderance (60 patients). Here, 32.14% of patients had primary LTS; the remaining were metastases. Clinical presentation included nonspecific back pain (57.83%), weakness (21.69%) and radicular [...] Read more.
The study cohort consisted of 83 patients with a mean age of 49.55 (SD 13.72) with a female preponderance (60 patients). Here, 32.14% of patients had primary LTS; the remaining were metastases. Clinical presentation included nonspecific back pain (57.83%), weakness (21.69%) and radicular pain (18.07%). History of uterine neoplasia was found in 33.73% of patients. LTS preferentially affected the thoracic spine (51.81%), followed by the lumbar (21.67%) spine. MRI alone was the most common imaging modality (33.33%); in other cases, it was used with CT (22.92%) or X-ray (16.67%); 19.23% of patients had Resection/Fixation, 15.38% had Total en bloc spondylectomy, and 10.26% had Corpectomy. A minority of patients had laminectomy and decompression. Among those with resection, 45.83% had a gross total resection, 29.17% had a subtotal resection, and 16.67% had a near total resection. Immunohistochemistry demonstrated positivity for actin (43.37%), desmin (31.33%), and Ki67 (25.30). At a follow-up of 19.3 months, 61.97% of patients were alive; 26.25% of 80 patients received no additional treatment, 23.75% received combination radiotherapy and chemotherapy, only chemotherapy was given to 20%, and radiotherapy was given to 17.5%. Few (2.5%) had further resection. For an average of 12.50 months, 42.31% had no symptoms, while others had residual (19.23%), other metastasis (15.38%), and pain (7.69%). On follow-up of 29 patients, most (68.97%) had resolved symptoms; 61.97% of the 71 patients followed were alive. Full article
(This article belongs to the Special Issue Bone and Spine Metastases)
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