A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer

Daniel M. Sciubba, C. Rory Goodwin, Alp Yurter, Derek Ju, Ziya L. Gokaslan, Charles Fisher, Laurence D. Rhines, Michael G. Fehlings, Daryl R. Fourney, Ehud Mendel, Ilya Laufer, Chetan Bettegowda, Shreyaskumar R. Patel, Y. Raja Rampersaud, Arjun Sahgal, Jeremy Reynolds, Dean Chou, Michael H. Weber, Michelle J. Clarke

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Study Design Review of the literature. Objective Surgery and cement augmentation procedures are effective palliative treatment of symptomatic spinal metastases. Our objective is to systematically review the literature to describe the survival, prognostic factors, and clinical outcomes of surgery and cement augmentation procedures for breast cancer metastases to the spine. Methods We performed a literature review using PubMed to identify articles that reported outcomes and/or prognostic factors of the breast cancer patient population with spinal metastases treated with any surgical technique since 1990. Results The median postoperative survival for metastatic breast cancer was 21.7 months (8.2 to 36 months), the mean rate of any pain improvement was 92.9% (76 to 100%), the mean rate of neurologic improvement was 63.8% (53 to 100%), the mean rate of neurologic decline was 4.1% (0 to 8%), and the local tumor control rate was 92.6% (89 to 100%). Kyphoplasty studies reported a high rate of pain control in selected patients. Negative prognostic variables included hormonal (estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) receptor refractory tumor status, high degree of axillary lymph node involvement, and short disease-free interval (DFI). All other clinical or prognostic parameters were of low or insufficient strength. Conclusion With respect to clinical outcomes, surgery consistently yielded neurologic improvements in patients presenting with a deficit with a minimal risk of worsening; however, negative prognostic factors associated with shorter survival following surgery include estrogen receptor/progesterone receptor negativity, HER2 negativity, and a short DFI.

Original languageEnglish (US)
Pages (from-to)482-496
Number of pages15
JournalGlobal Spine Journal
Volume6
Issue number5
DOIs
StatePublished - Aug 1 2016

Fingerprint

Nervous System
Breast Neoplasms
Neoplasm Metastasis
Survival
Kyphoplasty
Pain
Progesterone Receptors
Palliative Care
PubMed
Estrogen Receptors
Progesterone
Neoplasms
Estrogens
Spine
Lymph Nodes
Population
human ERBB2 protein

Keywords

  • breast cancer
  • kyphoplasty
  • metastasis
  • spine
  • surgery
  • survival
  • tumor
  • vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer. / Sciubba, Daniel M.; Goodwin, C. Rory; Yurter, Alp; Ju, Derek; Gokaslan, Ziya L.; Fisher, Charles; Rhines, Laurence D.; Fehlings, Michael G.; Fourney, Daryl R.; Mendel, Ehud; Laufer, Ilya; Bettegowda, Chetan; Patel, Shreyaskumar R.; Rampersaud, Y. Raja; Sahgal, Arjun; Reynolds, Jeremy; Chou, Dean; Weber, Michael H.; Clarke, Michelle J.

In: Global Spine Journal, Vol. 6, No. 5, 01.08.2016, p. 482-496.

Research output: Contribution to journalReview article

Sciubba, DM, Goodwin, CR, Yurter, A, Ju, D, Gokaslan, ZL, Fisher, C, Rhines, LD, Fehlings, MG, Fourney, DR, Mendel, E, Laufer, I, Bettegowda, C, Patel, SR, Rampersaud, YR, Sahgal, A, Reynolds, J, Chou, D, Weber, MH & Clarke, MJ 2016, 'A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer', Global Spine Journal, vol. 6, no. 5, pp. 482-496. https://doi.org/10.1055/s-0035-1564807
Sciubba, Daniel M. ; Goodwin, C. Rory ; Yurter, Alp ; Ju, Derek ; Gokaslan, Ziya L. ; Fisher, Charles ; Rhines, Laurence D. ; Fehlings, Michael G. ; Fourney, Daryl R. ; Mendel, Ehud ; Laufer, Ilya ; Bettegowda, Chetan ; Patel, Shreyaskumar R. ; Rampersaud, Y. Raja ; Sahgal, Arjun ; Reynolds, Jeremy ; Chou, Dean ; Weber, Michael H. ; Clarke, Michelle J. / A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer. In: Global Spine Journal. 2016 ; Vol. 6, No. 5. pp. 482-496.
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abstract = "Study Design Review of the literature. Objective Surgery and cement augmentation procedures are effective palliative treatment of symptomatic spinal metastases. Our objective is to systematically review the literature to describe the survival, prognostic factors, and clinical outcomes of surgery and cement augmentation procedures for breast cancer metastases to the spine. Methods We performed a literature review using PubMed to identify articles that reported outcomes and/or prognostic factors of the breast cancer patient population with spinal metastases treated with any surgical technique since 1990. Results The median postoperative survival for metastatic breast cancer was 21.7 months (8.2 to 36 months), the mean rate of any pain improvement was 92.9{\%} (76 to 100{\%}), the mean rate of neurologic improvement was 63.8{\%} (53 to 100{\%}), the mean rate of neurologic decline was 4.1{\%} (0 to 8{\%}), and the local tumor control rate was 92.6{\%} (89 to 100{\%}). Kyphoplasty studies reported a high rate of pain control in selected patients. Negative prognostic variables included hormonal (estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) receptor refractory tumor status, high degree of axillary lymph node involvement, and short disease-free interval (DFI). All other clinical or prognostic parameters were of low or insufficient strength. Conclusion With respect to clinical outcomes, surgery consistently yielded neurologic improvements in patients presenting with a deficit with a minimal risk of worsening; however, negative prognostic factors associated with shorter survival following surgery include estrogen receptor/progesterone receptor negativity, HER2 negativity, and a short DFI.",
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AU - Goodwin, C. Rory

AU - Yurter, Alp

AU - Ju, Derek

AU - Gokaslan, Ziya L.

AU - Fisher, Charles

AU - Rhines, Laurence D.

AU - Fehlings, Michael G.

AU - Fourney, Daryl R.

AU - Mendel, Ehud

AU - Laufer, Ilya

AU - Bettegowda, Chetan

AU - Patel, Shreyaskumar R.

AU - Rampersaud, Y. Raja

AU - Sahgal, Arjun

AU - Reynolds, Jeremy

AU - Chou, Dean

AU - Weber, Michael H.

AU - Clarke, Michelle J.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Study Design Review of the literature. Objective Surgery and cement augmentation procedures are effective palliative treatment of symptomatic spinal metastases. Our objective is to systematically review the literature to describe the survival, prognostic factors, and clinical outcomes of surgery and cement augmentation procedures for breast cancer metastases to the spine. Methods We performed a literature review using PubMed to identify articles that reported outcomes and/or prognostic factors of the breast cancer patient population with spinal metastases treated with any surgical technique since 1990. Results The median postoperative survival for metastatic breast cancer was 21.7 months (8.2 to 36 months), the mean rate of any pain improvement was 92.9% (76 to 100%), the mean rate of neurologic improvement was 63.8% (53 to 100%), the mean rate of neurologic decline was 4.1% (0 to 8%), and the local tumor control rate was 92.6% (89 to 100%). Kyphoplasty studies reported a high rate of pain control in selected patients. Negative prognostic variables included hormonal (estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) receptor refractory tumor status, high degree of axillary lymph node involvement, and short disease-free interval (DFI). All other clinical or prognostic parameters were of low or insufficient strength. Conclusion With respect to clinical outcomes, surgery consistently yielded neurologic improvements in patients presenting with a deficit with a minimal risk of worsening; however, negative prognostic factors associated with shorter survival following surgery include estrogen receptor/progesterone receptor negativity, HER2 negativity, and a short DFI.

AB - Study Design Review of the literature. Objective Surgery and cement augmentation procedures are effective palliative treatment of symptomatic spinal metastases. Our objective is to systematically review the literature to describe the survival, prognostic factors, and clinical outcomes of surgery and cement augmentation procedures for breast cancer metastases to the spine. Methods We performed a literature review using PubMed to identify articles that reported outcomes and/or prognostic factors of the breast cancer patient population with spinal metastases treated with any surgical technique since 1990. Results The median postoperative survival for metastatic breast cancer was 21.7 months (8.2 to 36 months), the mean rate of any pain improvement was 92.9% (76 to 100%), the mean rate of neurologic improvement was 63.8% (53 to 100%), the mean rate of neurologic decline was 4.1% (0 to 8%), and the local tumor control rate was 92.6% (89 to 100%). Kyphoplasty studies reported a high rate of pain control in selected patients. Negative prognostic variables included hormonal (estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) receptor refractory tumor status, high degree of axillary lymph node involvement, and short disease-free interval (DFI). All other clinical or prognostic parameters were of low or insufficient strength. Conclusion With respect to clinical outcomes, surgery consistently yielded neurologic improvements in patients presenting with a deficit with a minimal risk of worsening; however, negative prognostic factors associated with shorter survival following surgery include estrogen receptor/progesterone receptor negativity, HER2 negativity, and a short DFI.

KW - breast cancer

KW - kyphoplasty

KW - metastasis

KW - spine

KW - surgery

KW - survival

KW - tumor

KW - vertebroplasty

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