Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine

Michelle J. Clarke, Camilo A. Molina, Daryl R. Fourney, Charles G. Fisher, Ziya L. Gokaslan, Meic H. Schmidt, Laurence D. Rhines, Michael G. Fehlings, Ilya Laufer, Shreyaskumar R. Patel, Y. Raja Rampersaud, Jeremy Reynolds, Dean Chou, Chetan Bettegowda, Ehud Mendel, Michael H. Weber, Daniel M. Sciubba

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Study Design: Systematic review. Objective: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. Methods: A systemic review of the literature was conducted to answer the following questions: Question 1. Describe the survival and functional outcomes of surgery or vertebral augmentation for prostate metastases to the spine. Question 2. Determine whether overall tumor burden, Gleason score, preoperative functional markers, and hormonal naivety favor operative intervention. Question 3. Establish whether clinical outcomes vary with the evolution of operative techniques. Results: A total of 16 studies met the preset inclusion criteria. All included studies were retrospective series with a level of evidence of IV. Included studies consistently showed a large effect of hormone-naivety on overall survival. Additionally, studies consistently demonstrated an improvement in motor function and the ability to maintain/regain ambulation following surgery resulting in moderate strength of recommendation. All other parameters were of insufficient or low strength. Conclusions: There is a dearth of literature regarding the surgical treatment of prostate metastases to the spine, which represents an opportunity for future research. Based on existing evidence, it appears that the surgical treatment of prostate metastases to the spine has consistently favorable results. While no consistent preoperative indicators favor nonoperative treatment, hormone-naivety and high Karnofsky performance scores have positive effects on survival and clinical outcomes.

Original languageEnglish (US)
Pages (from-to)460-468
Number of pages9
JournalGlobal Spine Journal
Volume7
Issue number5
DOIs
StatePublished - Aug 1 2017

Fingerprint

Prostate
Spine
Neoplasm Metastasis
Survival
Hormones
Surgical Decompression
Neoplasm Grading
Therapeutics
Tumor Burden
Walking
Neoplasms
Retrospective Studies
Quality of Life

Keywords

  • MESCC
  • metastatic spine tumor
  • outcomes
  • prostate cancer
  • prostate metastasis
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Clarke, M. J., Molina, C. A., Fourney, D. R., Fisher, C. G., Gokaslan, Z. L., Schmidt, M. H., ... Sciubba, D. M. (2017). Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine. Global Spine Journal, 7(5), 460-468. https://doi.org/10.1177/2192568217710911

Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine. / Clarke, Michelle J.; Molina, Camilo A.; Fourney, Daryl R.; Fisher, Charles G.; Gokaslan, Ziya L.; Schmidt, Meic H.; Rhines, Laurence D.; Fehlings, Michael G.; Laufer, Ilya; Patel, Shreyaskumar R.; Rampersaud, Y. Raja; Reynolds, Jeremy; Chou, Dean; Bettegowda, Chetan; Mendel, Ehud; Weber, Michael H.; Sciubba, Daniel M.

In: Global Spine Journal, Vol. 7, No. 5, 01.08.2017, p. 460-468.

Research output: Contribution to journalReview article

Clarke, MJ, Molina, CA, Fourney, DR, Fisher, CG, Gokaslan, ZL, Schmidt, MH, Rhines, LD, Fehlings, MG, Laufer, I, Patel, SR, Rampersaud, YR, Reynolds, J, Chou, D, Bettegowda, C, Mendel, E, Weber, MH & Sciubba, DM 2017, 'Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine', Global Spine Journal, vol. 7, no. 5, pp. 460-468. https://doi.org/10.1177/2192568217710911
Clarke MJ, Molina CA, Fourney DR, Fisher CG, Gokaslan ZL, Schmidt MH et al. Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine. Global Spine Journal. 2017 Aug 1;7(5):460-468. https://doi.org/10.1177/2192568217710911
Clarke, Michelle J. ; Molina, Camilo A. ; Fourney, Daryl R. ; Fisher, Charles G. ; Gokaslan, Ziya L. ; Schmidt, Meic H. ; Rhines, Laurence D. ; Fehlings, Michael G. ; Laufer, Ilya ; Patel, Shreyaskumar R. ; Rampersaud, Y. Raja ; Reynolds, Jeremy ; Chou, Dean ; Bettegowda, Chetan ; Mendel, Ehud ; Weber, Michael H. ; Sciubba, Daniel M. / Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine. In: Global Spine Journal. 2017 ; Vol. 7, No. 5. pp. 460-468.
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abstract = "Study Design: Systematic review. Objective: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. Methods: A systemic review of the literature was conducted to answer the following questions: Question 1. Describe the survival and functional outcomes of surgery or vertebral augmentation for prostate metastases to the spine. Question 2. Determine whether overall tumor burden, Gleason score, preoperative functional markers, and hormonal naivety favor operative intervention. Question 3. Establish whether clinical outcomes vary with the evolution of operative techniques. Results: A total of 16 studies met the preset inclusion criteria. All included studies were retrospective series with a level of evidence of IV. Included studies consistently showed a large effect of hormone-naivety on overall survival. Additionally, studies consistently demonstrated an improvement in motor function and the ability to maintain/regain ambulation following surgery resulting in moderate strength of recommendation. All other parameters were of insufficient or low strength. Conclusions: There is a dearth of literature regarding the surgical treatment of prostate metastases to the spine, which represents an opportunity for future research. Based on existing evidence, it appears that the surgical treatment of prostate metastases to the spine has consistently favorable results. While no consistent preoperative indicators favor nonoperative treatment, hormone-naivety and high Karnofsky performance scores have positive effects on survival and clinical outcomes.",
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AU - Schmidt, Meic H.

AU - Rhines, Laurence D.

AU - Fehlings, Michael G.

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AU - Patel, Shreyaskumar R.

AU - Rampersaud, Y. Raja

AU - Reynolds, Jeremy

AU - Chou, Dean

AU - Bettegowda, Chetan

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AU - Weber, Michael H.

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N2 - Study Design: Systematic review. Objective: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. Methods: A systemic review of the literature was conducted to answer the following questions: Question 1. Describe the survival and functional outcomes of surgery or vertebral augmentation for prostate metastases to the spine. Question 2. Determine whether overall tumor burden, Gleason score, preoperative functional markers, and hormonal naivety favor operative intervention. Question 3. Establish whether clinical outcomes vary with the evolution of operative techniques. Results: A total of 16 studies met the preset inclusion criteria. All included studies were retrospective series with a level of evidence of IV. Included studies consistently showed a large effect of hormone-naivety on overall survival. Additionally, studies consistently demonstrated an improvement in motor function and the ability to maintain/regain ambulation following surgery resulting in moderate strength of recommendation. All other parameters were of insufficient or low strength. Conclusions: There is a dearth of literature regarding the surgical treatment of prostate metastases to the spine, which represents an opportunity for future research. Based on existing evidence, it appears that the surgical treatment of prostate metastases to the spine has consistently favorable results. While no consistent preoperative indicators favor nonoperative treatment, hormone-naivety and high Karnofsky performance scores have positive effects on survival and clinical outcomes.

AB - Study Design: Systematic review. Objective: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. Methods: A systemic review of the literature was conducted to answer the following questions: Question 1. Describe the survival and functional outcomes of surgery or vertebral augmentation for prostate metastases to the spine. Question 2. Determine whether overall tumor burden, Gleason score, preoperative functional markers, and hormonal naivety favor operative intervention. Question 3. Establish whether clinical outcomes vary with the evolution of operative techniques. Results: A total of 16 studies met the preset inclusion criteria. All included studies were retrospective series with a level of evidence of IV. Included studies consistently showed a large effect of hormone-naivety on overall survival. Additionally, studies consistently demonstrated an improvement in motor function and the ability to maintain/regain ambulation following surgery resulting in moderate strength of recommendation. All other parameters were of insufficient or low strength. Conclusions: There is a dearth of literature regarding the surgical treatment of prostate metastases to the spine, which represents an opportunity for future research. Based on existing evidence, it appears that the surgical treatment of prostate metastases to the spine has consistently favorable results. While no consistent preoperative indicators favor nonoperative treatment, hormone-naivety and high Karnofsky performance scores have positive effects on survival and clinical outcomes.

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