Spinal Metastasis: Diagnosis, Treatment and Prognosis - Integrative Review From 2012 to 2017

Abstract

Care of the patient with spinal metastasis is challenging. The topic of this article is the treatment and prognosis of spinal metastases, aiming to enumerate and analyze literature that addresses this treatment and prognosis. The methodology used was an integrative review in the Virtual Health Library. Nineteen articles were identified demonstrating that there is research and scientific production in this area. The thematic units and their categories are: treatment decision - prognostic scales or clinical neurological evaluation; types of treatment - minimally invasive and/or traditional; and effectiveness of prognostic scales higher or lower probability of success, which provide insight into the different possibilities of patient evaluation and their applicability in practice. When making the diagnosis, planning the treatment, and establishing a prognosis, the professional must be in sync with current precepts and act based on the objective and subjective characteristics of the patients, such as beliefs and values, which although immeasurable, influence the survival and the effectiveness of treatment. Level of evidence I; Integrative Review.

Outcomes and survival of spinal metastasis with epidural compression

“…[ 10 11 13 15 16 19 ] Contrary to what was reported in other countries, metastases of primary lung tumor were less frequent in our patients as well as in local reports. [ 10 13 15 19 20 ] This finding may be related to the lack of target therapies in our country, which has increased the survival of these patients. It was not possible to identify the primary tumor in 7 (6.8%) patients.…”

“…[ 1 2 4 ] The thoracic spine was the most frequent location, and breast and prostate spinal metastases were the most frequently observed primary tumor in our patients and other reports of the same country. [ 10 11 13 15 16 19 ] Contrary to what was reported in other countries, metastases of primary lung tumor were less frequent in our patients as well as in local reports. [ 10 13 15 19 20 ] This finding may be related to the lack of target therapies in our country, which has increased the survival of these patients.…”

“…[ 11 12 13 ] The therapeutic decision of spinal metastases has considered the nature of the primary tumor, the patient's overall clinical condition, neurological status, and survival scales. [ 1 7 14 15 16 ] However, it is very difficult to predict the prognosis of a patient with spinal metastasis and choose the best treatment option.…”

Use of paclitaxel carried in lipid core nanoparticles in patients with late-stage solid cancers with bone metastases: Lack of toxicity and therapeutic benefits

“…Pathological fractures and skeletal-related events that may appear in bone metastatic disease [6] , [56] , [57] occurred in none of the 18 patients during the total 104 treatment cycles performed in the study. Likewise, nerve-related complications resulting from progression of bone metastases [58] , [59] did not occur during the study.…”