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Volume 7, Issue 1 (Winter 2021)
Iran J Neurosurg 2021, 7(1): 37-48 |
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Vieira Netto L A, Araújo Peres L F, Matos Pereira N, Jardim Zaccariotti A, Arruda Zaccariotti V, Silva Marques R A, et al . Outcomes of Surgical Decompression for Spinal Metastases From Gynecological Cancers: A Retrospective Cohort Study. Iran J Neurosurg 2021; 7 (1) :37-48
URL: http://irjns.org/article-1-250-en.html
URL: http://irjns.org/article-1-250-en.html
Luiz Alves Vieira Netto1 
, Luís Felipe Araújo Peres1 , Nayara Matos Pereira2 , Alice Jardim Zaccariotti1 , Vladimir Arruda Zaccariotti2 , Romulo Alberto Silva Marques2 , João Batista Arruda2 , Edésio Martins1 , Rodrigo Alves De Carvalho Cavalcante2 * 3
, Luís Felipe Araújo Peres1 , Nayara Matos Pereira2 , Alice Jardim Zaccariotti1 , Vladimir Arruda Zaccariotti2 , Romulo Alberto Silva Marques2 , João Batista Arruda2 , Edésio Martins1 , Rodrigo Alves De Carvalho Cavalcante2 * 3
1- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
2- Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
3- Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil. ,drigocavalcante@yahoo.com.br
2- Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil.
3- Department of Neurological Surgery, Clinics Hospital of the Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil. ,
Abstract: (2798 Views)
Background and Aim: Gynecological cancer is one of the most common types of cancer worldwide. Nonetheless, spinal metastasis from gynecological cancer is scarcely reported in the literature. In cases of spinal cord compression, the standard treatment is a decompressive surgery followed by radiotherapy treatment for selected patients. This study aimed to report the overall survival and surgical results in patients presenting with gynecological spinal metastases who underwent spinal cord/nerve root decompression and stabilization.
Methods and Materials/Patients: A total of 18 patients were included in this study. The surgical procedures were performed from 2012 to 2019. The evaluation of neurological status, spinal stability, and pain were performed using the American Spinal Injury Association Impairment Scale (ASIA), Spinal Instability Neoplastic Score (SINS), and Visual Analogue Scale (VAS), respectively.
Results: The lumbar spine was the most affected location (n=30; 50.0%). Regarding the preoperative neurological deficits, 16 cases (n=16; 88.9%) presented ASIA graded A–D before the surgery, being reduced to five (n=5; 27.8%) after the procedures. The pain level means (pre-and postoperative) were 9.39±0.79 and 2.28±1.44. The overall median survival was 6.1 months (95% Confidence Interval [CI] of 1.10–11.13 months). The mean survival of ambulatory and non-ambulatory patients before the surgery was 7.36 months and 3.2 months, respectively (P=0.007 – Log-rank Mantel–Cox).
Conclusion: Decompressive surgery and stabilization promote mechanical pain relief, spinal stability, an improvement of neurological function, and indirectly improving quality of life, despite a dismal overall survival of patients who present with metastatic spinal compression disease.
Methods and Materials/Patients: A total of 18 patients were included in this study. The surgical procedures were performed from 2012 to 2019. The evaluation of neurological status, spinal stability, and pain were performed using the American Spinal Injury Association Impairment Scale (ASIA), Spinal Instability Neoplastic Score (SINS), and Visual Analogue Scale (VAS), respectively.
Results: The lumbar spine was the most affected location (n=30; 50.0%). Regarding the preoperative neurological deficits, 16 cases (n=16; 88.9%) presented ASIA graded A–D before the surgery, being reduced to five (n=5; 27.8%) after the procedures. The pain level means (pre-and postoperative) were 9.39±0.79 and 2.28±1.44. The overall median survival was 6.1 months (95% Confidence Interval [CI] of 1.10–11.13 months). The mean survival of ambulatory and non-ambulatory patients before the surgery was 7.36 months and 3.2 months, respectively (P=0.007 – Log-rank Mantel–Cox).
Conclusion: Decompressive surgery and stabilization promote mechanical pain relief, spinal stability, an improvement of neurological function, and indirectly improving quality of life, despite a dismal overall survival of patients who present with metastatic spinal compression disease.
Keywords: Female genital neoplasms, Neoplasm metastasis, Spinal cord compression, Epidural neoplasms
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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