ウチノ カズヤ   Kazuya Uchino
  内野 和也
   所属   川崎医科大学  医学部 臨床医学 脊椎・災害整形外科学
   職種   臨床助教9年
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Liaison Treatment for Metastatic Spinal Tumors.
掲載誌名 正式名:Spine surgery and related research
略  称:Spine Surg Relat Res
ISSNコード:2432261X/2432261X
掲載区分国内
巻・号・頁 4(3),223-228頁
著者・共著者 Nakanishi Kazuo, Uchino Kazuya, Watanabe Seiya, Iba Hideaki, Hasegawa Toru
発行年月 2020/03/19
概要 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