• Ori Barzilai, Anne L Versteeg, Arjun Sahgal, Laurence D Rhines, Mark H Bilsky, Daniel M Sciubba, James M Schuster, Michael H Weber, Pal Varga Peter P National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary., Stefano Boriani, Chetan Bettegowda, Michael G Fehlings, Yoshiya Yamada, Michelle J Clarke, Paul M Arnold, Ziya L Gokaslan, Charles G Fisher, Ilya Laufer, and The Ao Spine Knowledge Forum Tumor Research Department, AOSpine International, Davos, Switzerland..
• Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York.
• Cancer. 2019 Mar 1; 125 (5): 770-778.

BackgroundThe treatment of oligometastatic (≤5 metastases) spinal disease has trended toward ablative therapies, yet to the authors' knowledge little is known regarding the prognosis of patients presenting with oligometastatic spinal disease and the value of this approach. The objective of the current study was to compare the survival and clinical outcomes of patients with cancer with oligometastatic spinal disease with those of patients with polymetastatic (>5 metastases) disease.MethodsThe current study was an international, multicenter, prospective study. Patients who were admitted to a participating spine center with a diagnosis of spinal metastases and who underwent surgical intervention and/or radiotherapy between August 2013 and May 2017 were included. Data collected included demographics, overall survival, local control, and treatment information including surgical, radiotherapy, and systemic therapy details. Health-related quality of life (HRQOL) measures included the EuroQOL 5 dimensions 3-level questionnaire (EQ-5D-3L), the 36-Item Short Form Health Survey (SF-36v2), and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ).ResultsOf the 393 patients included in the current study, 215 presented with oligometastatic disease and 178 presented with polymetastatic disease. A significant survival advantage of 90.1% versus 77.3% at 3 months and 77.0% versus 65.1% at 6 months from the time of treatment was found for patients presenting with oligometastatic disease compared with those with polymetastatic disease. It is important to note that both groups experienced significant improvements in multiple HRQOL measures at 6 months after treatment, with no differences in these outcome measures noted between the 2 groups.ConclusionsThe treatment of oligometastatic disease appears to offer a significant survival advantage compared with polymetastatic disease, regardless of treatment choice. HRQOL measures were found to improve in both groups, demonstrating a palliative benefit for all treated patients.© 2018 American Cancer Society.

24 keywords...

hide…