New Data on Impact of Spine Tumor Location

A retrospective cohort study has found that when it comes to spine tumors, the location is critical.

Their work, “The Impact of Metastatic Spinal Tumor Location on 30-Day Perioperative Mortality and Morbidity After Surgical Decompression,” appears in the June 1, 2018 edition of Spine.

Co-author Samuel K. Cho, M.D., chief of Spine Surgery at Mount Sinai West, and director, Spine Surgery Fellowship Mount Sinai Health System told OTW, “Spine is one of the most common organs for bony metastasis. We as spine surgeons take care of tumor patients, but we as individual spine surgeons, unless you work at a tertiary cancer center, do not take care of enough tumor patients to have adequate data for meaningful research.”

The authors wrote, “The purpose of this study was to assess the impact of tumor location in the cervical, thoracic, or lumbosacral spine on 30-day perioperative mortality and morbidity after surgical decompression of metastatic extradural spinal tumors.”

“We identified 2,238 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent laminectomy for excision of metastatic extradural tumors in the cervical, thoracic, or lumbosacral spine…”

“On univariate analysis, cervical spine tumors were associated with the highest rate of pulmonary complications. Multivariate regression analysis demonstrated that cervical spinal tumors had the highest odds of multiple perioperative complications.”

“However, thoracic spinal tumors were associated with the highest risk of intra- or postoperative blood transfusion. In contrast, patients with metastatic tumors in the lumbosacral spine had lower odds of perioperative mortality, pulmonary complications, and sepsis.”

Dr. Cho commented to OTW, “By utilizing a national surgical database, we were able to have a high-level view of perioperative complications that can happen to these patients depending on the location of tumor in the spine.”

“Just like real estate, location matters when treating spin tumor patients. Surgeons should be cognizant of different complication risk profile of their patients depending on tumor location. Tumor location is an independent risk factor for perioperative mortality and morbidity after surgical decompression of metastatic spinal tumors. The addition of tumor location to existing prognostic scoring systems may help to improve their predictive accuracy.”