19 Harley St, London, W1G 9QJ, UK
We are London's Top Spine Clinic

Factors associated with improved outcomes following decompressive surgery for prostate cancer metastatic to the spine.

Related Articles

Factors associated with improved outcomes following decompressive surgery for prostate cancer metastatic to the spine.

Neurosurgery. 2013 Oct;73(4):657-66; discussion 666

Authors: Ju DG, Zadnik PL, Groves ML, Hwang L, Kaloostian PE, Wolinksy JP, Witham TF, Bydon A, Gokaslan ZL, Sciubba DM

BACKGROUND: Metastatic spinal cord compression from prostate cancer is a debilitating disease causing neurological deficits, mechanical instability, and intractable pain. Surgical management may improve quality of life.
OBJECTIVE: To define postoperative outcomes and explore associations with prolonged survival for patients with metastatic prostate cancer.
METHODS: Retrospective chart reviews were performed of all patients undergoing spinal surgery for metastatic cancer from June 1, 2002 to August 31, 2011. Patient demographics, surgical details, adjuvant therapies, outcomes, complications, and postoperative survival were reviewed.
RESULTS: Twenty-seven patients with prostate cancer underwent surgery at a median age of 65 years (range, 46-82 years). After surgery, 93% of patients had preserved or improved neurological status, 56% of nonambulatory patients recovered ambulation, 43% of incontinent patients recovered continence, and 23% experienced complications. Postoperative Frankel grades were significantly improved by at least 1 letter grade at 1 month (P = .03). The median analgesic and steroid usage was significantly lower up to 3 months and 6 months postoperatively, respectively (P = .007, .005). Median survival following surgery was 10.2 months, and patients with castration-resistant prostate cancer had a shorter median survival than those with hormone-naïve disease (9.8 vs 40 months). Better preoperative performance status was an independent predictor of survival (P = .02). Younger age (P = .005) and instrumentation greater than 7 spinal levels (P = .03) were associated with complications.
CONCLUSION: Spinal surgery for prostate metastases improves neurological function and decreases analgesic requirements. Our findings support surgical intervention for carefully selected patients, and knowledge of preoperative hormone sensitivity and performance status may help with risk stratification.

PMID: 23839521 [PubMed – indexed for MEDLINE]

Share to care...

Share on facebook
Share on twitter
Share on pinterest
Share on google
Share on linkedin
Share on skype

What we do...

The Harley Street Hospital


What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

We treat all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

What our patients say about us ......