Metastatic Spine Tumor Epidemiology: Comparison of Trends in Surgery Across Two Decades and Three Continents

Wright, Ernest; Ricciardi, Federico; Arts, Mark P.; Buchowski, Jacob M.; Chung, Chun Kee; Coppes, Maarten H.; Crockard, Alan; Depreitere, Bart; Fehlings, Michael G.; Kawahara, Norio; Lee, Chong Suh; Leung, Yuk‐Man; Martin-Benlloch, Antonio; Massicotte, Eric M.; Mazel, Christian; Öner, Cumhur; Peul, Wilco C.; Quraishi, Nasir A.; Tokuhashi, Yasuaki; Tomita, Katsuro; Ulbricht, Christian; Verlaan, Jorrit‐Jan; Wang, Mike; Choi, David

doi:10.1016/j.wneu.2018.03.091

Cited by 54 publications

(55 citation statements)

References 24 publications

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“…Perhaps these results are regional characteristics peculiar to the three-neurosurgical divisions operating profiles inserted into their Heath Institutions contexts. This knowledge is in accordance to Wright et al, 2018 (28) that surgical habits have been fairly consistent among countries worldwide and over time, as reported in a comparative study of trends in surgery across two decades and three continents in metastatic spine tumor epidemiology.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of spinal metastases: a descriptive cross-sectional update and literature review / Prevalência em metástases espinais: atualização de estudo transversal descritiva e revisão da literatura

Daniel

Veiga

2019

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introduction: A measure of an epidemiological event occurrence contributes in institutional health planning, resource allocation, sickness trend prediction and a surgical divisions operating profile. Objective: Census in prevalence of spinal epidural metastases among spinal and spinal tissue neoplasms in the neurosurgical context is the encountered epidemiological literature gap and the proposed reason for this research. Methods: A surgically treated spinal neoplasms patient descriptive cross-sectional update census was performed between February 1997 and January 2018 in a single neurosurgical division. In addition, using the systematic research method for literature review, authors selected comparative descriptive studies in patients submitted to surgical procedures for spinal epidural metastases, epidural primary and intradural neoplasms. The methodological quality analysis was in accordance to the Oxford Centre for Evidence-Based Medicine. Results: The primary outcome obtained in the cross-sectional descriptive update study indicated that 128 neurologically symptomatic patients were submitted to surgical procedures for spinal metastases and represented 0.84% of the 15,061-neurosurgical procedures. As for the secondary outcome, literature review identified 3 comparative studies: 1 cross-sectional and 2 case-series. In a cohort of 866 (100%) patients submitted to surgical treatment, 191 (22.05%) patients were operated for spinal metastases, 83 (9.59%) for epidural primary neoplasms and 592 (68.36%) for intradural neoplasms. Clinical appraisals identified Grade C recommendation for the 3 included items. Conclusion: Spinal intradural neoplasms are prevalent when compared to spinal metastases and spinal metastases are the most common histologic tumor type group in patients submitted to surgical treatment.Keywords: Neoplasm metastasis; Epidemiology; Spine; Surgical procedures, operativeRESUMOIntrodução: À medida que ocorra um evento epidemiológico, o mesmo contribuirá no planejamento do atendimento à saúde numa Instituição no tocante à alocação de recursos, à previsão de tendências de doenças e a caracterização do perfil de procedimentos cirúrgicos de um departamento de cirurgia. Objetivo: Estabelecer censo na prevalência de metástases epidurais dentre as neoplasias da coluna vertebral e do tecido nervoso nela contido. No contexto neurocirúrgico é a lacuna epidemiológica encontrada na literatura e o motivo proposto desta pesquisa. Métodos: Foi realizado um censo de atualização descritiva transversal de pacientes submetidos a cirurgias espinhais no período entre fevereiro de 1997 e janeiro de 2018 em uma única divisão neurocirúrgica. Ademais, utilizando o método de pesquisa sistemática para revisão da literatura, os autores selecionaram estudos descritivos comparativos de pacientes com diagnóstico de neoplasias epidurais secundárias, epidurais primárias e intradurais submetidos a procedimentos cirúrgicos em coluna vertebral. A análise metodológica da qualidade dos estudos foi realizada de acordo com o Oxford Center for Evidence-Based Medicine. Resultados: O desfecho primário obtido no estudo de atualização descritiva transversal indicou que 128 pacientes neurologicamente sintomáticos foram submetidos a procedimentos cirúrgicos em metástases espinhais e representaram 0,84% do total de 15.061 procedimentos neurocirúrgicos em geral. Quanto ao desfecho secundário, a revisão de literatura identificou 3 estudos comparativos: 1 transversal e 2 séries de casos. Em uma coorte de 866 (100%) pacientes submetidos a tratamento cirúrgico, 191 (22,05%) foram operados para metástases espinhais, 83 (9,59%) para neoplasias primárias epidurais e 592 (68,36%) para neoplasias intradurais. A análise metodológica da qualidade dos estudos identificou recomendação Grau C para os 3 itens incluídos. Conclusão: As neoplasias intradurais da coluna vertebral são prevalentes quando comparadas às metástases espinhais e estas últimas são o tipo histológico mais comum em pacientes submetidos a tratamento cirúrgico em coluna vertebral.Descritores: metástase neoplásicas, Epidemiologia, Coluna vertebral, Procedimentos cirúrgicos operatórios

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Section: Discussionsupporting

confidence: 92%

Prevalence of spinal metastases: a descriptive cross-sectional update and literature review / Prevalência em metástases espinais: atualização de estudo transversal descritiva e revisão da literatura

Daniel

Veiga

2019

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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“…analyzed patients with spinal metastases from the Netherlands and found that the most common primary tumor was breast cancer, followed by lung cancer, prostate cancer, kidney cancer, and others. Similarly, an epidemiological study of spinal metastases across two decades and three continents showed that the most common primary tumor was breast cancer, followed by prostate cancer, lung cancer, kidney cancer, and others. A nationwide epidemiological study of adult Koreans with spinal metastases showed that the most common primary tumor was lung cancer, followed by liver cancer, breast cancer, colon cancer, and others.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the number of epidemiological studies on spinal metastases has been gradually increasing worldwide. A spinal metastases epidemiology study that compared surgery trends across two decades and three continents concluded that surgical habits had been fairly consistent among countries worldwide and over time. Moreover, the study of Sohn et al .…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Characteristics of 1196 Patients with Spinal Metastases: A Retrospective Study

Feng

Zhang

Yang

et al. 2019

Orthopaedic Surgery

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Objectives: To describe the epidemiological characteristics of patients with spinal metastases between 2007 and 2019. Methods: Patients with spinal metastases were identified from several clinical centers in China between January 2007 and July 2019. Demographics, primary tumor types, spinal involvement, and Clinical indicators of each patient were reviewed.Results: A total of 1196 patients were included in this study, 717 males (59.95%) and 479 females (40.05%), with a male to female ratio of 1.50:1. Most patients (63.71%) were in the ages range of 50 to 69 years. The mean age was 58.6 AE 11.6 (range 13-89) years and the median age was 59.0 years. The average age of females was younger than that of males, and the difference was statistically significant. The proportion of male patients over 60 years old was higher than that of females, and the difference was statistically significant. The most common primary tumor was lung cancer (n = 437, 36.54%), followed by unknown origin (n = 194, 16.22%), kidney cancer (n = 78, 6.52%), breast cancer (n = 76, 6.35%), and liver/biliary cancer (n = 75, 6.27%). The most common primary tumor was lung cancer in both males and females, followed by unknown origin in males and breast cancer in females. There were 730 patients (61.04%) in the subgroup of the number<3; the highest level was lumbar vertebrae, with 250 patients (34.25%). The remaining 466 patients (38.96%) were included in the subgroup of the number ≥ 3; the highest level was tumor metastasis of multiple-level of spine, with 334 patients (71.67%). Among the 1196 patients, spinal cord injury occurred in 54.01% of patients, 76.34% of patients developed moderate and above pain, 55.69% of patients had metastatic spinal cord compression, and only 26.67% of patients had a clear history of primary tumors. Conclusion:This study provided a relatively detailed description of epidemiological characteristics in spinal metastases in China, which could assist orthopaedic surgeons to understand the clinical characteristics of spinal metastases, and is of great significance in guiding clinical diagnoses and scientific research.

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“…An epidemiological survey based on a population of spinal metastases in South-East Norway showed that prostate cancer, lung cancer and breast cancer accounted for 66% of all patients, followed by myeloma, lower gastrointestinal tumor, kidney cancer and tumors of unknown origin [7]. Another study comparing trends in surgical treatments of spinal metastases across two decades and three continents noted that colon cancer, liver cancer and lung cancer accounted for a higher proportion in Asian countries, while breast cancer, prostate cancer and myeloma had a lower proportion [18]. The authors believed that the difference was largely dependent on the different high-prevalence cancer types and different early screening programs in different parts of the world.…”

Section: Primary Tumor Typementioning

confidence: 99%

“…However, in more developed countries, prostate cancer is the most common cancer among male patients and lung cancer is the leading cause of cancer death among female patients [19]. In addition, the incidence of liver cancer in China is more than three times than that in North America and 10 times than that of some European countries; while the incidence of breast cancer in China is lower than that in North America [18].…”

Section: Primary Tumor Typementioning

confidence: 99%

A multicenter, descriptive epidemiologic survey of the clinical features of spinal metastatic disease in China

Zhang

Qiao

Yang

et al. 2020

Neurological Research

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Background: Spinal metastases have unique epidemiological features and treatment methods. Unfortunately, the relative scarcity of spinal metastases has limited the widespread development of descriptive epidemiological studies, especially in Asian countries. The purpose of this study was to describe the epidemiological characteristics of patients with metastatic spinal tumors in China between 2007 and 2019. Methods: From January 2007 and July 2019, data on patients with spinal metastases were collected from five cancer centers in China, and demographic characteristics, primary tumor types, segments and numbers of vertebral lesions, disease-related scores, and treatment methods were reviewed. Results: A total of 2228 patients with spinal metastases were reviewed in this study, including 1279 male patients and 949 female patients, and the male to female ratio was 1.35: 1. More than half of patients developed metastatic diseases between the ages of 50 years and 69 years (64%). Overall, lung cancer (824 cases, 37%) was the most common primary tumor type and the most common level of spinal involvement was multi-level of metastases (860 cases, 39%). 705 patients (32%) had undergone surgical treatments, 1028 patients (46%) had undergone radiotherapy for metastatic vertebrae, and 855 patients (38%) had received systemic treatments. The age, primary tumor type, number of involved vertebrae, Frankel grade, and spinal instability neoplastic score would affect the surgical decision-making. Conclusions: This study provides insight into the epidemiological characteristics of spinal metastasis and health care service utilization in spinal metastasis patients in China. Background With the continuous advancement of diagnostic technology and the prolonged survival of cancer patients, the incidence of spinal metastases in the population is increasing. The spine is the third most common site for distant metastases, behind the lungs and liver [1-3]. Overall, spinal metastases occur in 40%-70% of patients with malignant tumors, and 10%-20% of these patients will experience metastatic spinal cord compression, which is mainly manifested by severe spinal pain, impaired neurological function, and even accelerated process of dying [4-6].

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Metastatic Spine Tumor Epidemiology: Comparison of Trends in Surgery Across Two Decades and Three Continents

Abstract: Surgical habits have been fairly consistent among countries worldwide and over time. However, patient survival has improved in later years, perhaps due to medical advances in the treatment of cancer, improved patient selection, and operating earlier in the course of disease.

Cited by 54 publications

References 24 publications

Prevalence of spinal metastases: a descriptive cross-sectional update and literature review / Prevalência em metástases espinais: atualização de estudo transversal descritiva e revisão da literatura

Prevalence of spinal metastases: a descriptive cross-sectional update and literature review / Prevalência em metástases espinais: atualização de estudo transversal descritiva e revisão da literatura

Epidemiological Characteristics of 1196 Patients with Spinal Metastases: A Retrospective Study

A multicenter, descriptive epidemiologic survey of the clinical features of spinal metastatic disease in China

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