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European Spine Journal

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01-03-2013 | Original Article

Surgery and survival outcomes of 22 patients with epidural spinal cord compression caused by thyroid tumor spinal metastases

Authors: Dan Zhang, Huabin Yin, Zhipeng Wu, Xinghai Yang, Tielong Liu, Jianru Xiao

Published in: European Spine Journal | Issue 3/2013

Abstract

Purpose

The aim of this study was to discuss the clinical presentation, imaging findings, treatments received, and outcome of therapies for patients with epidural spinal cord compression caused by thyroid spinal metastases, with the goal of emphasizing the importance of surgery in this setting and discussing therapeutic plan for treating these patients.

Methods

A total of 22 patients with spinal cord compression due to thyroid tumor spinal metastases who received surgery in our department were identified from 2004 to 2011. The series of 22 patients collected from our institution over the past 7 years was used to discuss treatment options for thyroid cancer spinal metastases on the basis of literature review and our own extensive experience.

Results

The mean age of the patients in this study was 57 years (range 37–78 years). The duration of the preoperative symptoms was 1–24 months, with an average of approximately 6 months. All patients attained improvement of at least one level of the Frankel classification after surgery. Two patients received more than one operation at our institution. Two patients died during follow-up, two patients had stable disease, and all other patients maintained a disease-free status during follow-up.

Conclusions

As thyroid tumor spinal metastases have a favorable prognosis, a radical therapeutic attitude should be considered in decision-making. Dorsal spinal decompression through curettage and stabilization can preserve or restore neurological function for most patients. For patients who have more than one metastatic lesion of the spine, surgeries can be sequentially performed based on the urgency of the case. In addition to treatment of primary disease, surgery and bisphosphonate treatment are the most important therapies for these patients.

Shaha AR, Shah JP, Loree TR (1997) Differentiated thyroid cancer presenting initially with distant metastasis. Am J Surg 174(5):474–476PubMedCrossRef

Abdel-Wanis ME, Kawahara N, Murata A, Murakami H, Nambu K, Ueda Y, Tomita K (2002) Thyroid cancer spinal metastases: report on 25 operations in 14 patients. Anticancer Res 22(4):2509–2516PubMed

Stojadinovic A, Shoup M, Ghossein RA, Nissan A, Brennan MF, Shah JP, Shaha AR (2002) The role of operations for distantly metastatic well-differentiated thyroid carcinoma. Surgery 131(6):636–643PubMedCrossRef

Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27(3):165–176PubMedCrossRef

Tancioni F, Navarria P, Pessina F, Attuati L, Mancosu P, Alloisio M, Scorsetti M, Santoro A, Baena RR (2012) Assessment of prognostic factors in patients with metastatic epidural spinal cord compression (MESCC) from solid tumor after surgery plus radiotherapy: a single institution experience. Eur Spine J 21(1):146–148CrossRef

de Geus-Oei Lioe-Fee, Oei Hong-Yoe, Hennemann Georg, Krenning Eric P (2002) Sensitivity of 123I whole-body scan and thyroglobulin in the detection of metastases or recurrence differentiated thyroid cancer. Eur J Nuclear Med Mol Imaging 29(6):768–774CrossRef

Ozkan E, Gupta S (2011) Embolization of spinal tumors: vascular anatomy, indication, and technique. Tech Vasc Interv Radiol 14(3):129–140PubMedCrossRef

Demura S, Kawahara N, Murakami H, Abdel-Wanis ME, Kato S, Yoshioka K, Tomita K, Tsuchiya H (2011) Total en bloc spondylectomy for spinal metastases in thyroid carcinoma. J Neurosurg Spine 14(2):172–176 (Epub 24 Dec 2010)PubMedCrossRef

Li H, Gasbarrini A, Cappuccio M, Terzi S, Paderni S, Mirabile L, Boriani S (2009) Outcome of excisional surgeries for the patients with spinal metastases. Eur Spine J 18(10):1423–1430 (Epub 5 Aug 2009)PubMedCrossRef

10.

Delank KS, Wendtner C, Eich HT, Eysel P(2011)The treatment of spinal metastases. Dtsch Arztebl Int 108(5):71–79; quiz 80 (Epub 4 Feb 2011)

11.

Dominkus M, Krepler P, Schwameis E, Kotz R (1998) Surgical therapy of spinal metastases. Orthopade 27(5):282–286PubMed

12.

Saito T, Kondo T, Hozumi T, Karasawa K, Seichi A, Nakamura K (2005) Results of posterior surgery with intraoperative radiotherapy for spinal metastases. Eur Spine J 15(2):216–222 (Epub 13 Aug 2005)PubMedCrossRef

13.

Kushchayev S, Kushchayeva Y, Theodore N, Preul MC, Clark OH (2010) Percutaneous vertebroplasty for thyroid cancer metastases to the spine. Thyroid 20(5):555–560PubMedCrossRef

14.

Schlumberger M, Challeton C, De Vathaire F, Travagli JP, Gardet P, Lumbroso JD, Francese C, Fontaine F, Ricard M, Parmentier C (1996) Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med 37(4):598–605PubMed

15.

Brown AP, Greening WP, McCready VR, Shaw HJ, Harmer CL (1984) Radioiodine treatment of metastatic thyroid carcinoma: the Royal Marsden Hospital experience. Br J Radiol 57(676):323–327PubMedCrossRef

16.

Petrich T, Widjaja A, Musholt TJ, Hofmann M, Brunkhorst T, Ehrenheim C, Oetting G, Knapp WH (2001) Outcome after radioiodine therapy in 107 patients with differentiated thyroid carcinoma and initial bone metastases: side-effects and influence of age. Eur J Nucl Med 28(2):203–208PubMedCrossRef

17.

Orita Y, Sugitani I, Toda K, Manabe J, Fujimoto Y (2011) Zoledronic acid in the treatment of bone metastases from differentiated thyroid carcinoma. Thyroid 21(1):31–35 (Epub 8 Nov 2010)PubMedCrossRef

18.

Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gorman CA, Hay ID (1995) Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab 80(7):2041–2045PubMedCrossRef

19.

Ekman ET, Lundell G, Tennvall J, Wallin G (1990) Chemotherapy and multimodality treatment in thyroid carcinoma. Otolaryngol Clin North Am 23(3):523–527PubMed

20.

Shimaoka K, Schoenfeld DA, DeWys WD, Creech RH, DeConti R (1985) A randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma. Cancer 56(9):2155–2160PubMedCrossRef

21.

Wilson PC, Millar BM, Brierley JD (2004) The management of advanced thyroid cancer. Clin Oncol (R Coll Radiol) 16(8):561–568CrossRef

Title: Surgery and survival outcomes of 22 patients with epidural spinal cord compression caused by thyroid tumor spinal metastases
Authors: Dan Zhang
Huabin Yin
Zhipeng Wu
Xinghai Yang
Tielong Liu
Jianru Xiao
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 3/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2534-2

At a glance: The STEP trials

Springer Medicine

Surgery and survival outcomes of 22 patients with epidural spinal cord compression caused by thyroid tumor spinal metastases

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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