Update and Overview in Spine Metastases Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (25 February 2024) | Viewed by 979

Special Issue Editor

Department of Neurosurgery, Aulss 2 Marca Trevigiana, 31100 Treviso, Italy
Interests: spine surgery; endoscopy; neurosurgery; degenerative; neoplasms

Special Issue Information

Dear Colleagues,

Spinal metastasis is a common issue causing significant pain and disability in cancer patients. Patients with such an occurrence require prompt medical and surgical attention. A multidisciplinary chemotherapy, radiotherapy, and surgical treatment approach is commonly used. Unfortunately, there are still some “grey areas” in diagnostics and the definition of therapeutic choices for those patients that often delay or impede the best care. Solid decision-making systems must be developed to assist physicians and surgeons in choosing the most appropriate treatment for each patient with spinal metastasis. In particular, the literature still lacks consensus on the timing of surgical management based on neurological presentation and an indication of what patients should treat aggressively and those in which a more conservative approach is recommended. Such lack of consensus is especially true in secondary hospitals where the absence of a multidisciplinary approach often leads to inappropriate care for those patients. Additionally, the post-operative care of those patients and possible complications often lacks precise indications. This Special Issue aims to collect papers describing and analyzing diagnostics tools and algorithms, outcomes and decision-making strategies, and post-treatment palliative care in spine metastases patients. In order to highlight precise indications and avoid misconduct in collecting precious papers on different aspects of spine metastases management covering the state of the art for surgery, radiotherapy and medical and psychokinesis therapy.

Dr. Enrico Giordan
Guest Editor

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Keywords

  • spine
  • metastases
  • multidisciplinary
  • surgery
  • tumors

Published Papers (1 paper)

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Research

10 pages, 450 KiB  
Article
Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A Retrospective Study
Medicina 2023, 59(12), 2087; https://doi.org/10.3390/medicina59122087 - 28 Nov 2023
Viewed by 790
Abstract
Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we [...] Read more.
Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment. Materials and Methods: We reviewed consecutive cases of posterior decompression and/or instrumentation surgery for metastatic spinal tumors from 2008 to 2019. The BMCB involved a team of specialists in orthopedics, rehabilitation medicine, radiation oncology, radiology, palliative supportive care, oncology, and hematology. We compared demographics, eastern cooperative oncology group performance status (ECOGPS), Barthel index (BI), number of overall versus emergency surgeries, and primary tumors between patients before (2008–2012) and after (2013–2019) BMCB establishment. Results: A total of 226 patients including 33 patients before BMCB started were enrolled; lung cancer was the most common primary tumor. After BMCB establishment, the mean patient age was 5 years older (p = 0.028), the mean operating time was 34 min shorter (p = 0.025), the mean hospital stay was 34.5 days shorter (p < 0.001), and the mean BI before surgery was 12 points higher (p = 0.049) than before. Moreover, the mean number of surgeries per year increased more than fourfold to 27.6 per year (p < 0.01) and emergency surgery rates decreased from 48.5% to 29.0% (p = 0.041). Patients with an unknown primary tumor before surgery decreased from 24.2% to 9.3% (p = 0.033). Postoperative deterioration rates from 1 to 6 months after surgery of ECOGPS and BI after BMCB started were lower than before (p = 0.045 and p = 0.027, respectively). Conclusion: The BMCB decreased the emergency surgery and unknown primary tumor rate despite an increase in the overall number of spinal surgeries. The BMCB also contributed to shorter operation times, shorter hospital stays, and lower postoperative deterioration rates of ECOGPS and BI. Full article
(This article belongs to the Special Issue Update and Overview in Spine Metastases Treatment)
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