Survival after surgery for spinal metastases: a population-based study.

Area of Science:

• Oncology
• Neurosurgery
• Epidemiology

Background:

• Limited population-based data exist on survival outcomes for spinal surgery in metastatic cancer patients.
• Spinal metastases represent a significant challenge in cancer care, impacting patient quality of life and survival.

Purpose of the Study:

• To evaluate survival rates and complication patterns in patients undergoing surgery for spinal metastases in Ontario, Canada.
• To compare current survival data with a historical cohort from 1991-1998.

Main Methods:

• A population-based study utilizing health administrative databases in Ontario, Canada (2006-2016).
• Inclusion of 2646 patients who underwent surgery for spinal metastases.
• Assessment of overall survival, mortality rates by primary cancer type, and post-operative complications.

Main Results:

• Median survival time was 236 days. 90-day and 1-year mortality rates were 29% and 59%, respectively.
• Highest mortality observed in patients with melanoma, upper gastrointestinal, and lung cancers (50% mortality within 90 days).
• Longest median survival times were for thyroid (906 days), myeloma (830 days), and breast (644 days) cancers.

Conclusions:

• Significant differences in survivorship exist based on the primary tumor type.
• A shift in surgical treatment distribution for specific cancers over two decades suggests evolving management strategies.
• Potential improvements in survival may be attributed to advances in adjuvant therapies and personalized treatment approaches.