Back to Search
Start Over
A systematic review of interventions and outcomes in lung cancer metastases to the spine
A systematic review of interventions and outcomes in lung cancer metastases to the spine
- Source :
- Journal of Clinical Neuroscience. 62:66-71
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Seventy percent of cancer patients will have metastatic bone disease, most commonly in the vertebra. Prognosis of metastatic lung cancer is poor and treatment is mostly palliative. To-date, there is no systematic review on the ideal treatment for lung cancer with spinal metastases in regards to mortality. Literature searches were performed based on PRISMA guidelines for systematic review. Thirty-nine studies comprising 1925 patients treated for spinal metastases of lung cancer met inclusion criteria. All analyses were performed using SAS and SPSS. Data were analyzed for meaningful comparisons of baseline patient characteristics, primary cancer type, metastatic lesion characteristics, treatment modality, and clinical and radiologic outcomes. Significantly greater mean survival length was seen in the non-surgical group (8.5 months, SD 6.6, SEM 0.17) compared to the surgical group (7.5 months, SD 4.5, SEM 0.25; p = 0.013). There was no statistically significant survival difference between different types of primary lung cancer: NSCLC (8.3 months, SD 13.8, SEM 0.91) and SCLC (7.0 months, SD 4.6, SEM 0.46; p = 0.36). Number of vertebral levels involved per lesion also did not exhibit significant difference: single lesion (11.3 months, SD 6.8, SEM 2.2) and multiple lesions (13.8 months, SD 15.7, SEM 3.6; p = 0.64). For patients with symptomatic spinal metastases from lung cancer, non-operative approaches experience significantly better survival outcomes (p = 0.013). Future clinical studies are needed to determine the best treatment algorithm to help maximize outcomes and minimize mortality in metastatic lung cancer.
- Subjects :
- Male
Oncology
medicine.medical_specialty
Lung Neoplasms
Bone disease
Psychological intervention
Lesion
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
Internal medicine
medicine
Humans
Lung cancer
Spinal Neoplasms
business.industry
Cancer
General Medicine
Prognosis
medicine.disease
Vertebra
medicine.anatomical_structure
Neurology
030220 oncology & carcinogenesis
Female
Surgery
Neurology (clinical)
Neurosurgery
medicine.symptom
business
Spinal metastases
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09675868
- Volume :
- 62
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Neuroscience
- Accession number :
- edsair.doi.dedup.....9b7e4eed628c7432669b2f5b6baf0d89
- Full Text :
- https://doi.org/10.1016/j.jocn.2019.01.006