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[Evolution of Surgical Outcomes in Spinal Metastases from Solid Tumors: A Comparative Analysis over 2 Decades]
Fernando Pacheco Dos Santos Ferreira da Silva1, Pedro Reggiani Anzuatégui1,2, Ana Valéria Rigolino Teixeira1
1Serviço de Ortopedia Oncológica, Hospital Erasto Gaertner, Curitiba, PR, Brasil.
Objective:
To evaluate the evolution of surgical outcomes in patients undergoing surgery for spinal metastases from solid tumors over more than two decades in a single tertiary referral center.
Methods:
The present retrospective comparative study included 2 cohorts of patients who underwent surgical treatment for spinal metastases: cohort 1 (2002-2015) and cohort 2 (2018-2024). Overall survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Major postoperative complications (grades III-IV) were analyzed per patient and compared between cohorts.
Results:
A total of 301 patients were included (175 in cohort 1 and 126 in cohort 2). The more recent cohort demonstrated significantly improved overall survival (log-rank p < 0.001), with a hazard ratio for mortality of 0.61 (95%CI: 0.48-0.78) compared with the earlier cohort. Early survival at 30 and 90 days also improved in cohort 2. Overall complication rates were similar between groups; however, cohort 2 showed a significant reduction in local complications.
Conclusion:
Surgical outcomes for spinal metastases improved over time, particularly in early survival and the reduction of local complications. These findings suggest that refinement in patient selection, prognostic stratification, and multidisciplinary perioperative care may have contributed to this temporal improvement.
