[Treatment strategies for spinal metastases]

Area of Science:

• Oncology
• Neurosurgery
• Palliative Care

Context:

• Spinal metastases affect 10% of carcinoma patients, representing a systemic disease manifestation.
• Treatment decisions for spinal metastases are complex, influenced by numerous patient-specific and disease-related factors.

Purpose:

• To outline the current understanding and management strategies for spinal metastases in carcinoma patients.
• To emphasize the shift towards patient-centered care, focusing on palliation and quality of life.

Summary:

• Treatment of spinal metastases does not impact overall oncological prognosis.
• Therapeutic decisions are individualized, considering primary tumor, neurological status, spinal stability, disease extent, and patient prognosis.
• Surgical interventions are reserved for instability or neurological compromise, with evolving oncosurgical techniques.
• Multimodal treatment options include radiotherapy, chemotherapy, hormonal therapy, radiosurgery, embolization, and supportive medications.
• Multidisciplinary tumor board evaluation is crucial for optimal management.

Impact:

• Highlights the importance of palliative care and quality of life in managing spinal metastases.
• Provides a framework for clinical decision-making in a complex oncologic scenario.
• Underscores the evolving role of surgery and the necessity of a multidisciplinary approach.