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Goodwin CR, Ahmed AK, Boone C, Abu-Bonsrah N, Xu R, Germscheid N, Fourney DR, Clarke M, Laufer I, Fisher CG, Bettegowda C, Sciubba DM. The Challenges of Renal Cell Carcinoma Metastatic to the Spine: A Systematic Review of Survival and Treatment. Global Spine J 2018; 8:517-526. [PMID: 30258759 PMCID: PMC6149047 DOI: 10.1177/2192568217737777] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES The objective of this systematic review was to answer 2 key questions: (1) What is the clinical presentation and probability of symptomatic improvement following treatment for patients with renal cell carcinoma (RCC) of the spine? (2) What is the overall survival of patients diagnosed with spinal metastases from RCC? METHODS A literature review was performed to identify articles that reported on survival, clinical outcomes, and/or prognostic factors in the RCC population with spinal metastases from 1986 to 2016. RESULTS Forty-eight articles (807 patients) were included. The Fuhrman Nuclear Grade has been significantly associated with survival in previous studies but was underpowered in the current study. The Memorial Sloan-Kettering Cancer Center Score (MSKCC/Motzer) was also underpowered in the current study. From the time of spinal metastasis, the mean and median survival for patients with previously diagnosed primary RCC was 8.75 and 11.7 months, respectively, whereas synchronously diagnosed patients (primary RCC and spinal metastasis) had a mean and median survival of 6.75 and 11 months, respectively. Patients with a "low" (0-8), "intermediate" (9-11), or "high" (12-15) revised Tokuhashi score at initial presentation had a median survival of 5.4, 11.7, and 32.9 months, respectively. CONCLUSION Patients with either a synchronous or latent diagnosis of RCC survived greater than 6 months from the time of presentation. Initial Furhman grade, Tokuhashi score, and MSKCC/Motzer can be useful tools in informing patient-specific prognosis for those with metastatic RCC of the spine.
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Affiliation(s)
- C. Rory Goodwin
- Duke University Medical Center, Durham, NC, USA,These authors contributed equally to this manuscript.,C. Rory Goodwin, Department of Neurosurgery,
Duke University Medical Center, 200 Trent Drive, Durham, NC 27710, USA.
| | - A. Karim Ahmed
- The Johns Hopkins University School of Medicine, Baltimore, MD,
USA,These authors contributed equally to this manuscript
| | - Christine Boone
- The Johns Hopkins University School of Medicine, Baltimore, MD,
USA,These authors contributed equally to this manuscript
| | | | - Risheng Xu
- The Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | | | | | | | - Ilya Laufer
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Charles G. Fisher
- University of British Columbia, Vancouver, British Columbia,
Canada,Vancouver General Hospital, Vancouver, British Columbia,
Canada
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