• C Rory Goodwin, Vijay Yanamadala, Alejandro Ruiz-Valls, Nancy Abu-Bonsrah, Ganesh Shankar, Eric W Sankey, Christine Boone, Michelle J Clarke, Mark Bilsky, Ilya Laufer, Charles Fisher, John H Shin, and Daniel M Sciubba.
• Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
• World Neurosurg. 2016 Jul 1; 91: 510517.e4510-517.e4.

BackgroundHepatocellular carcinoma (HCC) frequently metastasizes to the spine. The impact of medical and/or surgical intervention on overall survival has been examined in a limited number of clinical studies, and herein we systematically review these data.MethodsWe performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles that reported survival, clinical outcomes, and/or prognostic factors associated with patients diagnosed with spinal metastases. The methodologic quality of each review was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool.ResultsThere were 26 articles (152 patients) that met the inclusion criteria and were treated with either surgery, radiotherapy, chemotherapy, and/or observation. There were 3 retrospective cohort studies, 17 case reports, 5 case series, and 1 longitudinal observational study. Of the patients with known overall survival after diagnosis of spinal metastasis, survival at 3 months, 6 months, 1 year, 2 years, and 5 years was 95.2%, 83.0%, 28.6%, 2.0%, and 1.4%, respectively. The median survival after diagnosis of the metastasis was 0.7 months in the patients who received no treatment, 7 months in the patients treated with surgical intervention alone, 6 months for patients who received chemotherapy and/or radiation, and 13.5 months in the patients treated with a combination of surgery and medical management. All other clinical or prognostic parameters were of low or insufficient strength.ConclusionsPatients diagnosed with HCC spinal metastasis have a 10.6-month overall survival. Further analysis of patients in prospective controlled trials will be essential to the development of treatment algorithms for these patients in the future.Copyright © 2016 Elsevier Inc. All rights reserved.

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