Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery!

Amelot, Aymeric; Balabaud, L.; Choi, David; Fox, Zoë; Crockard, H. A.; Albert, Todd J.; Arts, C M; Buchowski, Jacob M.; Bünger, Cody; Chung, Chun Kee; Coppes, Maarten H.; Depreitere, Bart; Fehlings, Michael G.; Harrop, James S.; Kawahara, Norio; Kim, E S; Lee, C S; Leung, Yuk‐Man; Liu, Z. J.; Martín-Benlloch, Juan Antonio; Massicotte, Eric M.; Meyer, Bernhard; Öner, F. Cumhur; Peul, Wilco C.; Quraishi, Nasir A.; Tokuhashi, Yasuaki; Tomita, Katsuro; Ulbricht, Christian; Verlaan, Jorrit Jan; Wang, M; Mazel, Christian

doi:10.1016/j.spinee.2015.07.440

Cited by 45 publications

(31 citation statements)

References 29 publications

(27 reference statements)

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“…In this series of 637 patients, 11% developed symptomatic VTE (72 of 637) with 6.0% (38 of 637) developing PE, and 1.3% (eight of 637) who died of this complication. Another, similar study reported a symptomatic VTE in 1.6% of patients undergoing surgery for symptomatic spinal metastases, but this study was designed to determine survival and not specifically evaluate the risk of symptomatic VTE [3]. Compared with similar VTE studies for spine and musculoskeletal tumor surgery, the findings are relatively high; particularly, the number of fatal PEs is unprecedented [5,9,17,19,27,28,30,32,36,39,42].…”

Section: Discussionmentioning

confidence: 95%

“…Compared with previous work, this study has a relatively large sample of patients with spinal metastases collected over the last 15 years and extensive followup considering the cohort's clinical characteristics [3,44]. In this series of 637 patients, 11% developed symptomatic VTE (72 of 637) with 6.0% (38 of 637) developing PE, and 1.3% (eight of 637) who died of this complication.…”

Section: Discussionmentioning

confidence: 99%

“…(2) identify the factors associated with the development of symptomatic VTE among patients receiving surgery for spine metastases; (3) assess the association between the development of postoperative symptomatic VTE and 1year survival among patients who underwent surgery for spine metastases; and (4) assess if chemoprophylaxis increases the risk of wound complications among patients who underwent surgery for spine metastases.…”

Section: Introductionmentioning

confidence: 99%

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High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Groot

Ogink

Pereira

et al. 2019

Clin Orthop Relat Res

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Background Cancer and spinal surgery are both considered risk factors for venous thromboembolism (VTE). However, the risk of symptomatic VTE for patients undergoing surgery for spine metastases remains undefined. Questions/purposes The purposes of this study were to: (1) identify the proportion of patients who develop symptomatic VTE within 90-days of surgical treatment for spine metastases; (2) identify the factors associated with the development of symptomatic VTE among patients receiving surgery for spine metastases; (3) assess the association between the development of postoperative symptomatic VTE and 1-year survival among patients who underwent surgery for spine metastases; and (4) assess if chemoprophylaxis increases the risk of wound complications among patients who underwent surgery for spine metastases. Methods Between 2002 and 2014, 637 patients at two hospitals underwent spine surgery for metastases. We considered eligible for analysis adult patients whose procedures were to treat cervical, thoracic, or lumbar metastases (including lymphoma and multiple myeloma). At followup after 90 days and 1 year, respectively, 21 of 637 patients (3%) and 41 of 637 patients (6%) were lost to followup. In general, we used 40 mg of enoxaparin or 5000 IUs subcutaneous heparin every 12 hours. Patients on preoperative chemoprophylaxis continued their initial medication postoperatively. All chemoprophylaxis was started 48 hours after surgery and continued day to day but was discontinued if a bleeding complication developed. Low-molecular-weight heparin (including enoxaparin and dalteparin, in general dosages of respectively 40 mg and 5000 IUs daily) was the most commonly used chemoprophylaxis in 308 patients (48%). Subcutaneous heparin was injected into 127 patients (20%); aspirin was used for 92 patients (14%); and warfarin was administered in 21 Each author certifies that neither he, nor any member of his immediate family, have funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his institution approved the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Groot

Ogink

Pereira

et al. 2019

Clin Orthop Relat Res

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“…Surgical treatment of metastatic spine disease has been shown to improve pain, obtain control of disease, and improve quality of life [ 10 – 12 ]. Indications for surgical intervention for these patients continue to expand [ 7 ]. Additionally, superior adjuvant treatment options of treating metastatic disease have resulted in improved overall long-term survival of these patients [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…As overall survival rates continue to increase, the rate of skeletal and in particular spinal metastases can be expected to increase [ 6 ]. Additionally, indications for surgical intervention are also continuing to expand [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Survival Outcomes and Factors Associated with Revision Surgery for Metastatic Disease of the Spine

Alamanda

Robinson

Kneisl

et al. 2018

Journal of Oncology

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Study Design Retrospective review of a prospective database. Objective Certain subset of patients undergoing surgical treatment for spinal metastasis will require a revision surgery in their disease course; however, factors predictive of revision surgery and survival outcomes are largely unknown. The goal of this study is to report on survival outcomes as well as factors predictive of revision surgery in this unique patient population. Methods A total of 55 patients who met the inclusion criteria were included from January 2010 to December 2015. Twelve (22%) of these patients underwent a revision surgery. Patient and tumor characteristics were summarized and survival outcomes were evaluated using Kaplan-Meier methods and Cox proportional hazards regression. Results Both the revision and the nonrevision groups were similarly matched with respect to spine disease burden, neurological status at time of initial presentation, primary malignancy types, and the use of adjuvant treatment modalities. Tumor progression (66.7%) was the most common reason for necessitating a revision followed by nonunion (16.7%), wound dehiscence (8.3%), and construct failure (8.3%). Following multivariate model selection procedures, smokers were found to have 3.5 times increased odds of undergoing revision compared to nonsmokers (p = 0.05). Analysis of survival curves showed that the median survival in the revision group was 3.0 years (95% CI: 1.5, 4.1), while the median survival in the nonrevision group was 1.5 years (95% CI: 1.1, 2.3; log-rank test, p = 0.105). Conclusion Despite aggressive treatment, tumor progression is the most common reason for revision surgery. Smoking is an independent risk factor for revision. Revision surgery should be considered in patients when indicated as it does not appear to detrimentally affect survival.

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Thoracolumbar Spinal Oncology in the Geriatric Population

Goldberg

Barzilai²,

Lockney³

et al. 2023

Treatment of Spine Disease in the Elderly

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Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery!

Cited by 45 publications

References 29 publications

High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Survival Outcomes and Factors Associated with Revision Surgery for Metastatic Disease of the Spine

Thoracolumbar Spinal Oncology in the Geriatric Population

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