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Spine metastases

Hesham Mostafa Zakaria, Lara Massie, Azam Basheer, David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Ian Lee, Brent Griffith, Farzan Siddiqui, Victor Chang
BACKGROUND CONTEXT: The current standard of care for prediction of survival of cancer staging is based on TNM staging. However, for patients with spinal metastasis, who all have identical stage IV disease, identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. Analytic morphometrics enables physicians to quantify patient frailty by measuring lean muscle mass. Morphometrics also predicts survival in patients with lung cancer metastases to the spine...
March 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Martha Nowosielski, Patrick Y Wen
The identification of more effective therapies for brain tumors has been limited in part by the lack of reliable criteria for determining response and progression. Since its introduction in 1990, the MacDonald criteria have been used in neuro-oncology clinical trials to determine response, but they fail to address issues such as pseudoprogression, pseudoresponse, and nonenhancing tumor progression that have arisen with more recent therapies. The Response Assessment in Neuro-Oncology (RANO) working group, a multidisciplinary international group consisting of neuro-oncologists, medical oncologists, neuroradiologists, neurosurgeons, radiation oncologists, and neuropsychologists, was formed to improve response assessment and clinical trial endpoints in neuro-oncology...
February 2018: Seminars in Neurology
Robert Foerster, B C John Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha S Jawad, C Ronald Kersh, Daniel Létourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian A Winey, Matthias Guckenberger
BACKGROUND: Stereotactic body radiotherapy (SBRT) of the spine provides superior tumor control, but vertebral compression fractures are increased and the pathophysiological process underneath is not well understood. Data on histopathological changes, particularly after salvage SBRT (sSBRT) following conventional irradiation, are scarce. OBJECTIVE: To investigate surgical specimens after sSBRT and primary SBRT (pSBRT) regarding histopathological changes. METHODS: We assessed 704 patients treated with spine SBRT 2006 to 2012...
March 14, 2018: Neurosurgery
Mathieu Gauthé, Nathalie Testart Dardel, Fernando Ruiz Santiago, Jessica Ohnona, Valérie Nataf, Françoise Montravers, Jean-Noël Talbot
OBJECTIVES: To develop criteria to improve discrimination between vertebral metastases from neuroendocrine tumours (NETs) and benign bone lesions on PET combined with CT using DOTA-D-Phe1 -Tyr3 -octreotide labelled with gallium-68 (68 Ga-DOTA-TOC). METHODS: In 535 NET patients,68 Ga-DOTA-TOC PET/CT examinations were reviewed retrospectively for vertebral CT lesions and/or PET foci. For each vertebral PET abnormality, appearance on CT, biological volume (BV), standardized uptake value (SUVmax ) and ratios to those of reference organs were determined...
March 12, 2018: European Radiology
Grzegorz Guzik
BACKGROUND: Thoracic spine cancer metastases is frequently the cause of neurological deficits. Despite the availability of diagnostics, delays in treatment are still quite common. The aim of this work is to analyze the reasons for delayed diagnostics and treatment, in patients with neurological deficits in the course of metastatic spine disease. METHODS: In our study patients medical data was analyzed from 2013 to 2015. The analysis covered the following aspects: symptoms of metastases, time of neurological deficits occurrence, where and when initial diagnostics were performed, time from diagnosis to proper surgical treatment in an oncological centre...
March 7, 2018: BMC Palliative Care
M Dosani, S Lucas, J Wong, L Weir, S Lomas, C Cumayas, C Fisher, S Tyldesley
Background: The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adverse events...
February 2018: Current Oncology
Rajendra Kumar, Meena Kumar, Kavin Malhotra, Shreyaskumar Patel
PURPOSE OF REVIEW: Osteosarcoma is mostly seen in bones of children and young adults. When it occurs in older persons, the tumor is considered secondary usually complicating Paget disease or irradiated bone. However, there is a second incidence peak of primary osteosarcoma later in life when these tumors occur de novo. This article describes the clinical, imaging, and treatment of POS in older patients, including demographic data of patients from our institution. FINDINGS: We present our experience with 920 cases of osteosarcoma that were seen between 1984 and 2003 at the University of Texas MD Anderson Cancer Center in Houston, TX, USA...
February 28, 2018: Current Oncology Reports
D Adler, M Kriegsmann, P Sinn, A Schneeweiss, H Almansour, B Lehner, M Akbar
Breast cancer is the most common malignancy affecting women and the spinal column is most likely affected by metastases. Modern oncologic treatment options have significantly prolonged survival times in the last decade. Therefore, treatment of vertebral metastases has been of special interest in spine surgery. Different scores are described to evaluate prognosis and to choose correct treatment strategies, which however only differentiate tumor entities and not specific tumor phenotypes. Breast cancer has been classified into five intrinsic subtypes with different survival rates since the turn of the millennium...
February 27, 2018: Der Orthopäde
Ori Barzilai, Charles G Fisher, Mark H Bilsky
Treatment paradigms for patients with spine metastases have evolved significantly over the past decade. Incorporating stereotactic radiosurgery into these paradigms has been particularly transformative, offering precise delivery of tumoricidal radiation doses with sparing of adjacent tissues. Evidence supports the safety and efficacy of radiosurgery as it currently offers durable local tumor control with low complication rates even for tumors previously considered radioresistant to conventional radiation. The role for surgical intervention remains consistent, but a trend has been observed toward less aggressive, often minimally invasive, techniques...
February 22, 2018: Neurosurgery
Nicholas J Szerlip, Alexandra Calinescu, Eleanor Smith, Rebecca Tagett, Katrina L Clines, Henry H Moon, Russell S Taichman, Catherine H Van Poznak, Gregory A Clines
BACKGROUND: Thirty per cent of cancer patients develop spine metastases with a substantial number leading to spinal cord compression and neurological deficits. Many demonstrate a propensity toward metastasis to the posterior third of the vertebral body. The dura, the outer layer of the meninges, lies in intimate contact with the posterior border of the vertebral body and has been shown to influence adjacent bone. The effects of the dura on bone marrow and cancer cells have not been examined...
February 15, 2018: Neurosurgery
Pooja Pal, Bikramjit Singh, Shubhada Kane, Pankaj Chaturvedi
Though the association between follicular carcinoma and bone metastasis is well established, the site-wise distribution is not known. One hundred seventy-three patients of follicular carcinoma presenting between 2003 and 2011 were selected from 1093 patients of follicular lesions presenting at a single institution. Of these, 59 (34%) with bone metastasis were included in the study. Fifty of the 59 patients (84.7%) had metastasis at presentation, while 9 developed bone metastasis during follow-up. Sixty-one percent had solitary metastasis, 15 (25...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Hongsik Kim, Kyung Sik Yi, Won-Dong Kim, Seung-Myoung Son, Yaewon Yang, Jihyun Kwon, Hye Sook Han
Dural metastasis from primary gastric adenocarcinoma has been rarely reported, and its prognosis is very poor because it frequently leads to acute subdural hematoma. Here, we describe a case with sequential spinal and cranial dural metastases from gastric adenocarcinoma without subdural hematoma. A 43-year-old woman with gastric adenocarcinoma and well-controlled peritoneal carcinomatosis presented with back pain, right radiating leg pain, left facial palsy, and hearing loss. Magnetic resonance imaging of the spine and brain revealed dural masses at the lumbosacral junction with invasion to the L5 and S1 nerve roots and at the skull base with invasion to the internal auditory canal...
February 7, 2018: World Journal of Gastroenterology: WJG
Stylianos Kapetanakis, Danai Chourmouzi, Grigorios Gkasdaris, Vasileios Katsaridis, Eleftherios Eleftheriadis, Panagiotis Givissis
Paragangliomas are benign neoplasms that arise from the autonomic nervous system and the associated paraganglia. Although benign, they have been shown to possess metastatic potential. Involvement of the spine is rare. Even rarer is considered the involvement of the cervical spine. We report a case of a patient with a history of an extra-adrenal non-functional paraganglioma of the jugular foramen which was initially treated with intra-arterial embolization. After a 3-year disease-free follow-up, the patient was presented with symptoms of spinal cord compression due to spinal metastases in C2 and C3 vertebrae...
February 2018: Journal of Surgical Case Reports
Anne L Versteeg, Arjun Sahgal, Laurence D Rhines, Daniel M Sciubba, James M Schuster, Michael H Weber, Peter Pal Varga, Stefano Boriani, Chetan Bettegowda, Michael G Fehlings, Michelle J Clarke, Paul M Arnold, Ziya L Gokaslan, Charles G Fisher
BACKGROUND: The Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ) was developed as the first spine oncology-specific health-related quality of life (HRQOL) measure. This study evaluated the psychometric properties and clinical validity of the SOSGOQ in a diverse cohort of patients with spinal metastases. METHODS: An international, multicenter, prospective observational cohort study including patients with spinal metastases who underwent surgery and/or radiotherapy was conducted by the AOSpine Knowledge Forum Tumor...
February 6, 2018: Cancer
Jianru Xiao, Shaohui He, Jian Jiao, Wei Wan, Wei Xu, Dan Zhang, Weibo Liu, Nanzhe Zhong, Tielong Liu, Haifeng Wei, Xinghai Yang
PURPOSE: Multi-level reconstruction incorporating the chest wall and ribs is technically demanding after multi-segmental total en bloc spondylectomy (TES) of thoracic spinal tumours. Few surgical techniques are reported for effective reconstruction. A novel and straightforward technical reconstruction through posterior-lateral approach was presented to solve the extensive chest wall defect and prevent occurrences of severe respiratory dysfunctions after performing TES. The preliminary outcomes of surgery were reviewed...
February 5, 2018: International Orthopaedics
Takeshi Kuroshima, Mayumi Wada, Takehiko Sato, Masashi Takano, Shujiroh Makino
A 78-year-old male patient was referred to the Department of Oral Surgery, Hokuto Hospital (Obihiro, Japan) for painless swelling on the left neck and tongue. Histopathological examination of a biopsy specimen resulted in a diagnosis of squamous cell carcinoma of the tongue. Imaging examinations revealed cervical lymph node metastases on both sides, along with diffuse uptake of 18F-fluorodeoxyglucose (FDG) in the bone marrow of the spine and pelvis. Hematologic tests revealed an increased white blood cell (WBC) count and serum concentrations of granulocyte colony stimulating factor (G-CSF)...
January 2018: Oncology Letters
Michael T Perry, Ronnie Sebro
RATIONALE AND OBJECTIVES: To assess whether the accuracy of opposed-phase magnetic resonance (MR) imaging to differentiate spinal metastases from benign lesions is influenced by treatment. MATERIALS AND METHODS: We retrospectively evaluated 25 benign lesions, 25 untreated spinal metastases, and 89 treated spinal metastases in 101 patients who underwent opposed-phase MR spine imaging at our institution. The largest possible region of interest was placed over the lesion in question on out-of-phase and in-phase MR sequences, and the signal intensity ratio (SIR) of the lesions was calculated...
February 2, 2018: Academic Radiology
Seok Hahn, Young Han Lee, Jin-Suck Suh
OBJECTIVE: To compare the diagnostic performance of modified Dixon (mDxion) turbo spin echo (TSE) T2-weighted MRI and conventional T1-weighted MRI in vertebral metastasis detection. METHODS: Between September 2014 and October 2016, 33 patients with 68 metastases who had undergone whole-spine MRI were enrolled. The following sagittal image sets were evaluated: T1WI, and mDixon TSE T2-weighted water and fat images. Two radiologists independently evaluated each image-set for metastasis...
February 2, 2018: British Journal of Radiology
Maryam Dosani, Scott Tyldesley, Brendan Bakos, Jeremy Hamm, Tim Kong, Sarah Lucas, Jordan Wong, Mitchell Liu, Sarah Hamilton
INTRODUCTION: The TEACHH score was developed to identify patients with predicted short (< 3 months) and long (> 1 year) life expectancy. We aimed to validate this model in an independent group of patients presenting for palliative spine radiotherapy and to compare it to alternate prognostic models. METHODS: We retrospectively reviewed charts of 195 consecutive patients referred for palliative spine radiotherapy. Patients were grouped according to the number of risk factors from the TEACHH model, Chow model, and Oswestry Risk Index...
February 1, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Wangmi Liu, Yun Liang, Chong Bian, Libo Jiang, Guoli Zheng, Jian Dong
The present study aimed to identify the underlying molecular mechanisms associated with spinal metastases. Gene expression profiles in cancellous bone samples from the spines of five patients with spinal metastases, with different primary cancers, and three normal control patients were measured using microarray analysis and subsequently compared. The differentially expressed genes (DEGs) identified were filtered using bioinformatics analyses followed by cluster analysis, gene ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses...
January 2018: Oncology Letters
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