Prolonged survival following aggressive treatment for metastatic breast cancer in the spine

详细信息    查看全文

• 作者：Patricia L. Zadnik (1) (3)
  Lee Hwang (1) (3)
  Derek G. Ju (1) (3)
  Mari L. Groves (1) (3)
  Jackson Sui (1) (3)
  Alp Yurter (1) (3)
  Timothy F. Witham (1) (4)
  Ali Bydon (1) (4)
  Jean-Paul Wolinsky (1) (4)
  Ziya L. Gokaslan (1) (4)
  Daniel M. Sciubba (1) (2)
  
• 关键词：Spine ; Tumor ; Breast cancer ; Metastasis ; Outcomes
• 刊名：Clinical & Experimental Metastasis
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：31
• 期：1
• 页码：47-55
• 全文大小：291 KB
• 作者单位：Patricia L. Zadnik (1) (3)
  Lee Hwang (1) (3)
  Derek G. Ju (1) (3)
  Mari L. Groves (1) (3)
  Jackson Sui (1) (3)
  Alp Yurter (1) (3)
  Timothy F. Witham (1) (4)
  Ali Bydon (1) (4)
  Jean-Paul Wolinsky (1) (4)
  Ziya L. Gokaslan (1) (4)
  Daniel M. Sciubba (1) (2)
  
  1. Department of Neurosurgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
  3. 1550 Orleans St, CRBII Rm 264, Baltimore, MD, 21287, USA
  4. 600?N Wolfe St, Meyer Building, Baltimore, MD, 21287, USA
  2. 600?N Wolfe St, Meyer 5-185, Baltimore, MD, 21231, USA
  
• ISSN：1573-7276

文摘

In 2007, members of our group reported a 21?month median survival for patients undergoing surgery for metastatic breast cancer in the spinal column. Cervical spine metastases were associated with decreased survival, Estrogen receptor positivity was associated with improved survival, and age and visceral metastases did not significantly impact survival. In the current study, we reassess these variables in the context of modern adjuvant therapies, and investigate the impact of the Spinal Instability Neoplastic Score (SINS). We report an observational cohort of 43 patients undergoing surgical resection for metastatic breast cancer of the spine treated at a single academic institution from June 2002 to August 2011. Patient medical records were reviewed in accordance with policies outlined by the University Institutional Review Board. Median overall survival following surgery for metastatic breast cancer in the spine was 26.8?months. 1?year overall survival was 66?%. 5?year-overall survival was 4?%. Age (p?=?0.12), preoperative functional status (p?=?0.17), location of metastasis (p?=?0.34), the presence of visceral metastases (p?=?0.68), and spinal instability (p?=?0.81) were not significant variables on survival analysis. Postoperative adjuvant therapy with a single modality (radiation or chemotherapy) was associated with a significantly lower median survival compared to dual therapy with chemotherapy and radiation (p?=?0.042). Patients that received radiation and chemotherapy after surgery were younger but demonstrated prolonged median survival versus single modality therapy. This data supports the concept that visceral metastases do not impact survival, however cervical spine lesions were not associated with decreased survival.