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European Spine Journal

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01-08-2015 | Original Article

Surgery and survival outcomes of 30 patients with neurological deficit due to clear cell renal cell carcinoma spinal metastases

Authors: Shuai Han, Ting Wang, Dongjie Jiang, Yang Yu, Yu Wang, Wangjun Yan, Wei Xu, Ming Cheng, Wang Zhou, Jianru Xiao

Published in: European Spine Journal | Issue 8/2015

Abstract

Purpose

The aim of this study was to provide some useful insights into the clinical and imaging presentations, treatment and prognostic factors in patients with neurological deficit caused by clear cell renal cell carcinoma (CCRCC) spinal metastases for the sake of designing individualized therapeutic plans for such patients.

Methods

A total of 30 patients with neurological deficit due to CCRCC spinal metastases who received surgery in our department were identified during an 8-year period from 2003 to 2012 and used for discussion of treatment options for CCRCC spinal metastases on the basis of literature review and our own experience.

Results

Univariate analysis showed that age (≤45 years/>45 years), visceral metastasis, Tomita score (3–5/6–8), Tokuhashi score (4–9/10–12) and radiotherapy were suggested as the potential prognostic factors. However, the multivariate Cox regression model showed that only Tokuhashi score was an independent prognostic factor.

Conclusions

Tokuhashi score 10 or more is a favorable prognostic factor of CCRCC spinal metastasis.

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Herrmann E, Bierer S, Wulfing C (2010) Update on systemic therapies of metastatic renal cell carcinoma. World J Urol 28(3):303–309PubMedCrossRef

Sundaresan N, Scher H, DiGiacinto GV, Yagoda A, Whitmore W, Choi IS (1986) Surgical treatment of spinal cord compression in kidney cancer. J Clin Oncol 4(12):1851–1856PubMed

Chen F, Fujinaga T, Shoji T, Miyahara R et al (2008) Pulmonary resection for metastasis from renal cell carcinoma. Interact Cardiovasc Thorac Surg 7(5):825–828PubMedCrossRef

Staehler M, Haseke N, Zilinberg E, Stadler T et al (2010) Complete remission achieved with angiogenic therapy in metastatic renal cell carcinoma including surgical intervention. Urol Oncol 28(2):139–144PubMedCrossRef

Zhang D, Xu W, Liu T, Yin H et al (2013) Surgery and prognostic factors of patients with epidural spinal cord compression caused by hepatocellular carcinoma metastases: retrospective study of 36 patients in a single center. Spine (Phila Pa 1976) 38(17):E1090–1095CrossRef

Jacobsen KD, Folleras G, Fossa SD (1994) Metastases from renal cell carcinoma to the humerus or the shoulder girdle. Br J Urol 73(2):124–128PubMedCrossRef

Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J (1999) Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 17(8):2530–2540PubMed

Smith EM, Kursh ED, Makley J, Resnick MI (1992) Treatment of osseous metastases secondary to renal cell carcinoma. J Urol 148(3):784–787PubMed

Tatsui CE, Suki D, Rao G, Kim SS et al (2014) Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma. J Neurosurg Spine 20(1):108–116PubMedCrossRef

10.

Ulmar B, Naumann U, Catalkaya S, Muche R et al (2007) Prognosis scores of Tokuhashi and Tomita for patients with spinal metastases of renal cancer. Ann Surg Oncol 14(2):998–1004PubMedCrossRef

11.

Laufer I, Sciubba DM, Madera M, Bydon A et al (2012) Surgical management of metastatic spinal tumors. Cancer Control 19(2):122–128PubMed

12.

Meyer F, Griesinger F, Willborn K, Sambale R, Thome C (2011) Treatment strategies for the multidisciplinary management of spinal metastasis. Dtsch Med Wochenschr 136(38):1907–1912PubMedCrossRef

13.

Kim CH, Chung CK, Jahng TA, Kim HJ (2011) Resumption of ambulatory status after surgery for nonambulatory patients with epidural spinal metastasis. Spine J 11(11):1015–1023PubMedCrossRef

14.

Moon KY, Chung CK, Jahng TA, Kim HJ, Kim CH (2011) Postoperative survival and ambulatory outcome in metastatic spinal tumors: prognostic factor analysis. J Korean Neurosurg Soc 50(3):216–223PubMedCentralPubMedCrossRef

15.

Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 15(11):1110–1113CrossRef

16.

Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T (2001) Surgical strategy for spinal metastases. Spine (Phila Pa 1976) 26(3):298–306CrossRef

17.

Riegel T, Schilling T, Sitter H, Benes L et al (2002) Analysis of factors affecting the prognosis of vertebral metastases. Zentralbl Neurochir 63(1):2–6PubMedCrossRef

18.

Ulmar B, Richter M, Cakir B, Muche R, Puhl W, Huch K (2005) The Tokuhashi score: significant predictive value for the life expectancy of patients with breast cancer with spinal metastases. Spine (Phila Pa 1976) 30(19):2222–2226CrossRef

19.

Faul CM, Flickinger JC (1995) The use of radiation in the management of spinal metastases. J Neurooncol 23(2):149–161PubMedCrossRef

20.

Halperin EC, Harisiadis L (1983) The role of radiation therapy in the management of metastatic renal cell carcinoma. Cancer 51(4):614–617PubMedCrossRef

21.

Gerszten PC, Burton SA, Ozhasoglu C, Vogel WJ et al (2005) Stereotactic radiosurgery for spinal metastases from renal cell carcinoma. J Neurosurg Spine 3(4):288–295PubMedCrossRef

22.

Nguyen QN, Shiu AS, Rhines LD, Wang H et al (2010) Management of spinal metastases from renal cell carcinoma using stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 76(4):1185–1192PubMedCrossRef

23.

Yamada Y, Bilsky MH, Lovelock DM, Venkatraman ES et al (2008) High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions. Int J Radiat Oncol Biol Phys 71(2):484–490PubMedCrossRef

24.

Klish DS, Grossman P, Allen PK, Rhines LD, Chang EL (2011) Irradiation of spinal metastases: should we continue to include one uninvolved vertebral body above and below in the radiation field. Int J Radiat Oncol Biol Phys 81(5):1495–1499PubMedCrossRef

25.

Coleman RE, McCloskey EV (2011) Bisphosphonates in oncology. Bone 49(1):71–76PubMedCrossRef

26.

Riccardi A, Grasso D, Danova M (2003) Bisphosphonates in oncology: physiopathologic bases and clinical activity. Tumori 89(3):223–236PubMed

27.

Veri A, D’Andrea MR, Bonginelli P, Gasparini G (2007) Clinical usefulness of bisphosphonates in oncology: treatment of bone metastases, antitumoral activity and effect on bone resorption markers. Int J Biol 22(1):24–33

28.

Bhatia S, Curti B, Ernstoff MS, Gordon M et al (2014) Recombinant interleukin-21 plus sorafenib for metastatic renal cell carcinoma: a phase 1/2 study. J Immunother Cancer 2:2PubMedCentralPubMedCrossRef

29.

Escudier B, Michaelson MD, Motzer RJ, Hutson TE et al (2014) Axitinib versus sorafenib in advanced renal cell carcinoma: subanalyses by prior therapy from a randomised phase III trial. Br J Cancer 110(12):2821–2828PubMedCentralPubMedCrossRef

30.

Giehl JP, Kluba T (1999) Metastatic spine disease in renal cell carcinoma—indication and results of surgery. Anticancer Res 19(2C):1619–1623PubMed

31.

Robial N, Charles YP, Bogorin I, Godet J et al (2012) Is preoperative embolization a prerequisite for spinal metastases surgical management. Orthop Traumatol Surg Res 98(5):536–542PubMedCrossRef

Title: Surgery and survival outcomes of 30 patients with neurological deficit due to clear cell renal cell carcinoma spinal metastases
Authors: Shuai Han
Ting Wang
Dongjie Jiang
Yang Yu
Yu Wang
Wangjun Yan
Wei Xu
Ming Cheng
Wang Zhou
Jianru Xiao
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3912-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Surgery and survival outcomes of 30 patients with neurological deficit due to clear cell renal cell carcinoma spinal metastases

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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