Clear Cell Renal Cell Carcinoma Spinal Metastases: Which Factors Matter to the Overall Survival? A 10-Year Experience of a High-Volume Tumor Spine Center.
Tokuhashi score
cear cell renal cell carcinoma
en-bloc resection
spinal metastases
visceral metastases
Journal
Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402
Informations de publication
Date de publication:
09 Oct 2022
09 Oct 2022
Historique:
received:
10
08
2022
revised:
23
09
2022
accepted:
06
10
2022
entrez:
27
10
2022
pubmed:
28
10
2022
medline:
28
10
2022
Statut:
epublish
Résumé
Clear cell renal cell carcinoma (ccRCC) usually spreads in the spinal region causing instability or spinal cord compression leading to neurological deficits. Therefore, surgical treatment is required for improving the outcome of patients. The aim of this study is to identify which prognostic factors could affect overall survival in patients affected by ccRCC. Methods: Retrospective cohort study of patients with ccRCC spinal metastases, surgically treated from November 2009 to April 2019. Demographic and clinical data were collected. The Kaplan−Meier method was used to estimate overall survival, and the log-rank test was used to evaluate differences in survival among potentially prognostic factors. Results: A total of 69 patients were surgically treated and followed up for a median period of 65 months. The average age at the time of surgery was 62.6 years old. The median overall survival (OS) was 34.7 months (95% CI 20.8−51.9) and 5-year OS was 31.2% (95% CI 19.2−44.1). A high Tokuhashi score (p = 0.0217), the presence of visceral metastases (p < 0.001), other bone metastases (p = 0.02012) and the kind of surgical treatment (p = 0.0395) are the main prognostic factors that influence the OS. Moreover, 3-year progression-free survival (PFS) was analyzed: the median PFS was 53.1 months and the % 3-year PFS was 62.9% (45.2−76.3). In the multivariate analysis, only pre-operative radiation therapy had a significant impact on 3-year PFS (95% CI 0.929−12.994, p = 0.0643). Conclusion: The results of this study suggest that the absence of visceral metastases and an aggressive surgery as en-bloc, when feasible, could prolong the survival rate and improve quality of life for patients.
Identifiants
pubmed: 36292130
pii: diagnostics12102442
doi: 10.3390/diagnostics12102442
pmc: PMC9600183
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Spinal Cord. 2020 Mar;58(3):318-323
pubmed: 31619752
World Neurosurg. 2021 Jun;150:e765-e770
pubmed: 33819707
Lancet Oncol. 2017 Dec;18(12):e720-e730
pubmed: 29208438
Curr Opin Urol. 2020 Jul;30(4):534-541
pubmed: 32453005
Urol Oncol. 2017 Mar;35(3):102-110
pubmed: 28089416
Cancer Sci. 2021 Jun;112(6):2416-2425
pubmed: 33780597
World Neurosurg. 2021 Oct;154:e398-e405
pubmed: 34280537
Radiol Case Rep. 2017 Aug 16;12(4):775-779
pubmed: 29484069
Cancer. 2010 May 1;116(9):2250-7
pubmed: 20209611
Crit Rev Oncol Hematol. 2018 May;125:19-29
pubmed: 29650272
Eur J Cancer. 2019 Jan;107:79-85
pubmed: 30551078
Eur Urol Oncol. 2021 Feb;4(1):102-111
pubmed: 31786162
Neurosurgery. 2019 Mar 1;84(3):647-654
pubmed: 29618107
J Neurosurg Spine. 2010 Jul;13(1):94-108
pubmed: 20594024
Cancer. 2019 Sep 1;125(17):2935-2944
pubmed: 31225907
Spine (Phila Pa 1976). 2010 Jul 1;35(15):1466-70
pubmed: 20195197
ESMO Open. 2020 Nov;5(6):e001079
pubmed: 33246931
J Clin Neurosci. 2020 Aug;78:73-78
pubmed: 32600973
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e597-605
pubmed: 22608954
Eur Rev Med Pharmacol Sci. 2004 Nov-Dec;8(6):265-74
pubmed: 15745386
Urol Clin North Am. 2020 Nov;47(4):419-431
pubmed: 33008493
Indian J Surg Oncol. 2018 Mar;9(1):97-104
pubmed: 29563746
Front Oncol. 2021 Jun 16;11:659779
pubmed: 34221976
Eur Urol. 2021 Dec;80(6):712-723
pubmed: 33824031
Jpn J Clin Oncol. 2019 May 1;49(5):395-403
pubmed: 30722031
Eur Spine J. 2016 Mar;25(3):673-8
pubmed: 26626082
Eur Urol. 2019 Jan;75(1):74-84
pubmed: 30243799
Clin Neurol Neurosurg. 2014 Jul;122:80-6
pubmed: 24908223
Spec Care Dentist. 2009 Jul-Aug;29(4):147-8
pubmed: 19573040
J Clin Oncol. 2011 Aug 1;29(22):3072-7
pubmed: 21709187
Oncologist. 2013 Jun;18(6):744-51
pubmed: 23709750
Ann Med Surg (Lond). 2018 Jan 31;27:9-16
pubmed: 29511536
Cancer Sci. 2012 Sep;103(9):1695-700
pubmed: 22642767
Global Spine J. 2018 Aug;8(5):517-526
pubmed: 30258759
J Neurosurg Spine. 2016 Aug;25(2):256-63
pubmed: 27058499