An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report

Spratt, Daniel E.; Beeler, Whitney H.; Moraes, Fábio Ynoe de; Rhines, Laurence D.; Gemmete, Joseph J.; Chaudhary, Neeraj; Shultz, David; Smith, Sean R.; Berlin, Alejandro; Dahele, Max; Slotman, Ben J.; Younge, K. C.; Bilsky, Mark H.; Park, Paul; Szerlip, Nicholas

doi:10.1016/s1470-2045(17)30612-5

Cited by 243 publications

(256 citation statements)

References 82 publications

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“…Any cancer has the potential to metastasise to the spine, but MSCC most commonly presents in breast, lung and prostate cancer, lymphoma and myeloma. Advances in cancer treatment have resulted in higher long-term survival rates after cancer, therefore the risk of developing MSCC is increasing (Bowers, 2015;Spratt et al, 2017). Signs of MSCC centre on spinal pain and neurological symptoms as summarised in figure 1.…”

Section: Introductionmentioning

confidence: 99%

Nursing considerations for supporting cancer patients with metastatic spinal cord compression: a literature review

Troke

Andrewes

2019

Br J Nurs

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Background: metastatic spinal cord compression (MSCC) is an oncology emergency. Prevalence is increasing. Treatment and care are complex and those diagnosed may be faced with life-changing challenges. Aims: to review the impact and management of MSCC in patients with cancer, in order to analyse nursing considerations for supporting patients. Methods: a literature review and thematic analysis of five primary research papers, published between 2009 and 2014. Findings: two themes of prognosis/survival time and independence versus dependence were discovered. Conclusions: the onset of MSCC may result in paralysis and associated loss of independence, impacting on a patient's quality of life. Understanding individuals' prognosis and treatment/care preferences is fundamental for the sensitive, individualised support of patients with MSCC. The findings reinforce the nurses' role in health education, in order to raise awareness of MSCC and promote early diagnosis so that patients maintain function and independence as long as possible. The findings support the need for nurses to be equipped with appropriate communication skills to initiate and engage in sensitive, difficult and proactive conversations with patients and their families, supporting the delivery of humanised care.

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Section: Introductionmentioning

confidence: 99%

Nursing considerations for supporting cancer patients with metastatic spinal cord compression: a literature review

Troke

Andrewes

2019

Br J Nurs

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“…The combination of SBRT with separation surgery is especially recommended in radioresistant or already irradiated metastases with spinal canal involvement [14] while conventional radiotherapy (EBRT) is still treatment of choice in radiosensitive entities. Recommendations that involve the mentioned techniques are based on frameworks/algorithms [14,15] that cover the question for stability (e.g. SINS [16,17]) of metastastic lesions, accompanying neurological deteriotation by epidural tumor involvement (i.e.…”

Section: Discussionmentioning

confidence: 99%

Current surgical strategies for treating spinal tumors: Results of a questionnaire survey among members of the German Spine Society (DWG)

Disch

Kleber

Redemann

et al. 2020

European Journal of Surgical Oncology

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“…Therefore, after the appearance of SBRT, conventional radiotherapy can be performed for radiotherapy‐sensitive tumors, and the effect of traditional radiotherapy on spinal cord tissue can be avoided for radiotherapy‐insensitive tumors. The radiotherapy target area was designed according to the scope of tumor invasion of different patients with preoperative magnetic resonance imaging (MRI), and the dura border could be determined according to the computed tomography (CT) scan results of postoperative vertebral angiography, so that all kinds of spinal metastases can be satisfactorily controlled by SBRT.…”

Section: Introductionmentioning

confidence: 99%

Efficacy Analysis of Separation Surgery Combined with SBRT for Spinal Metastases—A Long‐Term Follow‐Up Study Based on Patients with Spinal Metastatic Tumor in a Single‐Center

Liu

Zhou

Shi

et al. 2020

Orthopaedic Surgery

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Objective: Follow-up data of patients with spinal metastatic tumors were analyzed to investigate the effect of separation surgery combined with SBRT on clinical outcomes.Methods: The clinical data of 52 patients with spinal metastatic tumors admitted to our hospital from January 2015 to December 2018 were retrospectively analyzed. There were 24 males and 28 females, aged 25-77 years, with an average of 56.7 AE 7.4 years. The separation surgery of all patients was successfully completed and followed up. Frankel neurological function grading, Karnofsky performance scores, VAS scores, Epidural spinal cord compression (ESCC) grading and muscle strength grading were used to assess the patients' condition. Kaplan-Meier analysis and the Log•rank test were used to calculate the hazard ratio (HR) and the 95% feasible interval for patients with different ages, genders, and treatments. The multivariate Cox regression model was used to calculate the risk value HR and the 95% feasible interval in patients undergoing only separation surgery or separation surgery combined with SBRT.Results: After separation surgery, 46 patients had pain relief (88.5%), and the average VAS score decreased to 2.17 AE 0.52 points, which was significantly improved compared with preoperative score (P < 0.01). Muscle strength grading decreased in seven cases, showed no change in two cases, and recovered in 19 cases. Postoperative Frankel neurological function grading and Karnofsky performance scores were also significantly improved compared with preoperative scores (P < 0.01). The patients who accepted separation surgery were followed up for 9-47 months (26.3 AE 18.1 months), and 15 patients died due to the deterioration of the primary tumor. Thirteen patients received SBRT after surgery, including 12 cases of pain relief. The average VAS score of these 13 patients decreased to 1.64AE0.41 points, which was significantly improved compared with preoperative and postoperative (P < 0.01), and muscle strength recovered in eight cases. Frankel neurological function grading and Karnofsky performance scores of these patients were also significantly improved compared with preoperative and postoperative Frankel neurological function grading and Karnofsky performance scores (P < 0.01). The patients who accepted separation surgery combined with SBRT were followed up for 11-38 months (mean 22.5 AE 10.2 months), and five cases died of primary tumor. Univariate and multivariate analysis showed that separation surgery combined with SBRT was an independent predictor of overall survival rate (OS).Conclusions: Separation surgery combined with SBRT is an effective way to treat spinal metastatic tumors as it not only has smaller surgical trauma, but can also significantly relieve pain, improve nerve function, and relieve spinal cord compression.

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An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report

Cited by 243 publications

References 82 publications

Nursing considerations for supporting cancer patients with metastatic spinal cord compression: a literature review

Nursing considerations for supporting cancer patients with metastatic spinal cord compression: a literature review

Current surgical strategies for treating spinal tumors: Results of a questionnaire survey among members of the German Spine Society (DWG)

Efficacy Analysis of Separation Surgery Combined with SBRT for Spinal Metastases—A Long‐Term Follow‐Up Study Based on Patients with Spinal Metastatic Tumor in a Single‐Center

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