Seiya Watanabe
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Bone and Joint Surgery,
   Position   Instructor
Article types 原著
Language English
Peer review Peer reviewed
Title Liaison Treatment for Metastatic Spinal Tumors.
Journal Formal name:Spine surgery and related research
Abbreviation:Spine Surg Relat Res
ISSN code:2432261X/2432261X
Domestic / ForeginDomestic
Volume, Issue, Page 4(3),pp.223-228
Author and coauthor Nakanishi Kazuo, Uchino Kazuya, Watanabe Seiya, Iba Hideaki, Hasegawa Toru
Publication date 2020/03/19
Summary Introduction:The cancer board system employed at many hospitals and treatment centers involves multidisciplinary healthcare teams, including physicians, and the timing of treatment generally follows that of a consultation model. Thus, it is difficult to detect spinal metastases using the current implementation of the cancer board system, which can lead to delays in treatment. A new multidisciplinary treatment strategy for patients with metastatic spinal tumors was designed, and 745 patients were treated based on this strategy.Methods:In the first 5 years using the liaison treatment approach, 745 patients were diagnosed with metastatic spinal tumor. Tumors were discovered before a skeletal-related event (SRE) in 704 patients and after an SRE in 41 patients. We conducted our analysis in two patient groups: those with and without an SRE at the time of treatment initiation.Results:In most patients, the average spinal instability neoplastic score was 5.2, which indicates that we were able to detect the spinal tumor before a significant breakdown of the spinal support system. Ninety-five percent of patients were classified according to the Frankel grade classification during their initial diagnosis, and many patients initially underwent treatment before the onset of paralysis. Of patients with an SRE, 33% were Frankel grade E, indicating that approximately half were paralyzed at initial diagnosis. The median survival duration was prolonged by approximately 9 months in patients without an SRE compared with those with an SRE.Conclusions:Orthopedic spine surgeons are responsible for maintaining activities of daily living, improving quality of life, and prolonging life expectancy in patients with metastatic spinal tumors. The results of this study revealed that the liaison treatment system for metastatic spinal tumors has made it possible to successfully prevent SREs without neurological deficits and to prolong survival.
DOI 10.22603/ssrr.2019-0105
PMID 32864488