Details

Autor(en) / Beteiligte

• Linzey, Joseph R.
• Kathawate, Varun G.
• Strong, Michael J.
• Roche, Kayla
• Goethe, Peyton E.
• Tudrick, Lila R.
• Lee, Johan
• Tripathy, Arushi
• Koduri, Sravanthi
• Ward, Ayobami L.
• Ogunsola, Oludotun
• Zaki, Mark M.
• Joshi, Rushikesh S.
• Weyburne, Grant
• Mayo, Charles S.
• Evans, Joseph R.
• Jackson, William C.
• Szerlip, Nicholas J.

Titel

Patients with progression of spinal metastases who present to the clinic have better outcomes compared to those who present to the emergency department

Ist Teil von

• Cancer medicine (Malden, MA), 2023-10, Vol.12 (19), p.20177-20187

Ort / Verlag

Bognor Regis: John Wiley & Sons, Inc

Erscheinungsjahr

2023

Quelle

Wiley Online Library Journals

Beschreibungen/Notizen

• Background As cancer therapies have improved, spinal metastases are increasingly common. Resulting complications have a significant impact on patient's quality of life. Optimal methods of surveillance and avoidance of neurologic deficits are understudied. This study compares the clinical course of patients who initially presented to the emergency department (ED) versus a multidisciplinary spine oncology clinic and who underwent stereotactic body radiation therapy (SBRT) secondary to progression/presentation of metastatic spine disease. Methods We performed a retrospective analysis of a prospectively maintained database of adult oncologic patients who underwent spinal SBRT at a single hospital from 2010 to 2021. Descriptive statistics and survival analyses were performed. Results We identified 498 spinal radiographic treatment sites in 390 patients. Of these patients, 118 (30.3%) presented to the ED. Patients presenting to the ED compared to the clinic had significantly more severe spinal compression (52.5% vs. 11.7%; p < 0.0001), severe pain (28.8% vs. 10.3%; p < 0.0001), weakness (24.5% vs. 4.5%; p < 0.0001), and difficulty walking (24.5% vs. 4.5%; p < 0.0001). Patients who presented to the ED compared to the clinic were significantly more likely to have surgical intervention followed by SBRT (55.4% vs. 15.3%; p < 0.0001) compared to SBRT alone. Patients who presented to the ED compared to the clinic had a significantly quicker interval to distant spine progression (5.1 ± 6.5 vs. 9.1 ± 10.2 months; p = 0.004), systemic progression (5.1 ± 7.2 vs. 9.2 ± 10.7 months; p < 0.0001), and worse overall survival (9.3 ± 10.0 vs. 14.3 ± 13.7 months; p = 0.002). Conclusion The establishment of multidisciplinary spine oncology clinics is an opportunity to potentially allow for earlier, more data‐driven treatment of their spinal metastatic disease.