February 26, 2014
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Neurologic status at surgery affects metastatic spinal renal cell carcinoma survival

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Neurological status at surgery, the grade of the original nephrectomy specimen and activity of the systemic disease were factors found to influence a patient’s survival after spine surgery for metastatic spinal renal cell carcinoma in results of a study in The Journal of Neurosurgery: Spine.

Researchers retrospectively reviewed clinical data on a consecutive series of patients operated on for spinal metastasis of renal cell carcinoma (RCC) at the University of Texas MD Anderson Cancer Center. To determine the impact of the factors survival outcome, they analyzed demographic data, histopathological grade of the primary tumor, the timing of the surgery relative to diagnosis, treatment history before surgery, neurological status and systemic disease burden.

In the study results, Claudio E. Tatsui, MD, and colleagues reported 7.8% median overall 5 year overall survival (OS) after spine tumor resection in 267 patients with 11.3 months median OS. In patients with Fuhrman Grade 4 RCC the median OS was 6.1 months, which the investigators found was significantly lower than the 14.3 month survival they observed in patients with RCC that was Fuhrman Grade 3 or less, according to the results.

Compared with the 13.5 month median survival observed in patients with normal neurological examinations, patients who had preoperative neurological deficits had a median survival of 5.9 months. Median OS of a patient in which the spine as the only site of metastasis was 19 months after surgery. This was significantly longer than the 9.7 months observed in patients with additional spinal metastasis sites, according to the investigators

Researchers found that the median survival was 20.6 months in patients with non-progressing extra spinal metastasis compared with 5.6 months in patients with progressing metastasis.

Disclosure: The researchers report no relevant financial disclosures.