A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression

Sutcliffe, Paul; Connock, Martin; Shyangdan, D; Court, Rachel; Kandala, Ngianga‐Bakwin; Clarke, Aileen

doi:10.3310/hta17420

Cited by 125 publications

(109 citation statements)

References 166 publications

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“…Of the total bone metastases, the ratio of spinal metastasis was 54.7% (141/258 lesions). Our findings revealed that the number of bone metastases to the spine was lower compared to what was previously reported; in addition, the incidence of lumbar metastasis was relatively high compared to previous reports (6)(7)(8)(9)12). Overall survival depends mainly on the type of the primary tumor.…”

Section: Discussioncontrasting

confidence: 54%

“…Our findings revealed that the most frequent spinal metastatic site was the lumbar spine, followed by the thoracic and cervical spine. It was previously reported that the most frequent metastatic site was the thoracic spine, followed by the lumbar and cervical spine (6)(7)(8)(9). To explain this discrepancy, we compared the primary malignant tumor between the lumbar and thoracic metastatic groups.…”

Section: Resultsmentioning

confidence: 99%

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Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Shimada

Setoguchi

Yokouchi

et al. 2014

Molecular and Clinical Oncology

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Abstract.We analyzed the prognostic factors in patients with metastatic bone tumors and evaluated the efficacy of different modalities in identifying the primary lesions. A total of 145 patients with bone metastases who attended the orthopaedic outpatient clinic were included in this study. The most frequent site of bone metastases was the spine. The primary tumor type was differently distributed between patients with a known primary tumor at the first visit and those with an unknown primary lesion. The number of breast cancer cases was statistically significantly lower in the primary-unknown group. However, the number of myeloma cases was significantly higher in the primary-unknown group. Survival was significantly lower in the skeletal-related events (SREs) compared to that in the non-SREs group. Furthermore, survival was significantly worse in patients with a performance status (PS) of ≥2 compared to those with a PS of ≤1 and neurological complications occurred statistically more often in the group with worse PS (≥2). Survival rates were significantly lower in the non-spinal compared to those in the spinal metastatic group. Since the majority of breast cancer patients presented with metastasis in the spine, a breast cancer origin was a positive prognostic factor in patients with spinal metastases. Although there were no significant differences between computed tomography (CT) and 18 F-fluoro-2-deoxyglucose ( 18 F-FDG) positron emission tomography (PET)-CT in detecting primary lesions, CT may be the first choice due to its feasibility. In conclusion, lung cancer, SREs and worse PS were adverse prognostic factors for patients with bone metastasis. In addition, CT scans may be more useful for determining the primary lesion of a bone metastasis compared to 18 F-FDG PET-CT in a timelier manner.

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Section: Discussioncontrasting

confidence: 54%

Section: Resultsmentioning

confidence: 99%

Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Shimada

Setoguchi

Yokouchi

et al. 2014

Molecular and Clinical Oncology

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“…Para identificar una lesión osteolítica en una radiografía simple, debe ocurrir una pérdida del 30% al 50% de la densidad ósea; o en el caso de metástasis vertebral el colapso del cuerpo vertebral se observa después de que la mitad de la altura está comprometida 17,18 ; por consiguiente, es considerada una técnica con baja sensibilidad en metástasis tempranas o pequeñas, pero que puede dar gran información para evaluar la destrucción cortical por el cáncer y predecir el riesgo de fractura 19 .…”

Section: Diagnóstico Imagenológicounclassified

Rehabilitación del paciente con enfermedad ósea metastásica: Un desafío

Capacho¹,

Mojica

2016

Rev Col Med Fis Reh

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95Rehabilitación del paciente con enfermedad ósea metastásica: Un desafío Rev Col Med Fis Rehab 2016; 26(1): 95-108 ARTÍCULO DE REVISIÓN RESUMENLa enfermedad ósea metastásica es una condición que frecuentemente impacta de forma negativa la funcionalidad y calidad de vida de los pacientes con cáncer, por lo cual esta condición se convierte en un desafío para el grupo oncológico tratante y de soporte; en especial para los especialistas en rehabilitación, quienes deben buscar un equilibrio entre los riesgos de aparición de eventos adversos a causa de sus intervenciones y la preservación de la funcionalidad. El objetivo de esta revisión es dar a conocer las principales pautas sobre el diagnóstico clínico, el diagnóstico imagenológico, los fundamentos del tratamiento quirúrgico y las opciones en rehabilitación, para que el especialista pueda tomar las mejores decisiones de tratamiento y establecer objetivos de rehabilitación eficientes en los pacientes con enfermedad ósea metastásica.Palabras clave: metástasis de las neoplasias, hueso, rehabilitación. ABSTRACTThe bone metastases is a condition that often impresses of negative form the functionality and quality of life of the patients with cancer, for which dealer turns this condition into a challenge for the oncological group and of support; especially for the specialists in rehabilitation, who must look for a balance between the risks of appearance of adverse events because of its interventions and the preservation of the functionality. The object of this review is to announce the main rules on the clinical diagnosis, the imaging diagnosis, the essentials of the surgical treatment and the options in rehabilitation, so that the specialist could take the best decisions of treatment and establish efficient rehabilitation targets in the patients with bone metastases.

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“…107 Because of the rarity and heterogeneity of intradural metastatic disease and of ISCMs, precise molecular characterization of these tumors is less robust than that of bony metastatic disease. 108,115 Non-small cell lung cancer frequently metastasizes to the cranial CNS, but its occurrence within the spinal cord remains rare, being encountered in approximately 2% of patients with this disease. 77 Mutations in the anaplastic lymphoma kinase (ALK) gene in non-small cell lung cancer appear to predispose patients to earlier and more aggressive CNS involvement, with 1 recent case series reporting a 4.2% rate of ISCM in ALKpositive individuals.…”

Section: Disseminated Metastatic Cancersmentioning

confidence: 99%

“…7,99,108 Up to 70% of cancer patients have spinal metastatic disease at the time of death, with the most common types arising from lung, prostate, and breast cancers. 31 Intramedullary spinal cord metastasis (ISCM) is rare and is observed in fewer than 1% of all patients with systemic cancer.…”

Section: Disseminated Metastatic Cancersmentioning

confidence: 99%

The genetic basis of intradural spinal tumors and its impact on clinical treatment

Karsy

Guan

Sivakumar

et al. 2015

FOC

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Genetic alterations in the cells of intradural spinal tumors can have a significant impact on the treatment options, counseling, and prognosis for patients. Although surgery is the primary therapy for most intradural tumors, radiochemothera-peutic modalities and targeted interventions play an ever-evolving role in treating aggressive cancers and in addressing cancer recurrence in long-term survivors. Recent studies have helped delineate specific genetic and molecular differences between intradural spinal tumors and their intracranial counterparts and have also identified significant variation in therapeutic effects on these tumors. This review discusses the genetic and molecular alterations in the most common intradural spinal tumors in both adult and pediatrie patients, including nerve sheath tumors (that is, neurofibroma and schwannoma), meningioma, ependymoma, astrocytoma (that is, low-grade glioma, anaplastic astrocytoma, and glioblastoma), hemangioblastoma, and medulloblastoma. It also examines the genetics of metastatic tumors to the spinal cord, arising either from the CNS or from systemic sources. Importantly, the impact of this knowledge on therapeutic options and its application to clinical practice are discussed.

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A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression

Cited by 125 publications

References 166 publications

Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Rehabilitación del paciente con enfermedad ósea metastásica: Un desafío

The genetic basis of intradural spinal tumors and its impact on clinical treatment

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