Liu Shuzhong, Zhou Xi, Huo Zhen, Yao Siyuan, Wang Yipeng, Liu Yong
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
J Bone Oncol. 2020 Aug 2;24:100312. doi: 10.1016/j.jbo.2020.100312. eCollection 2020 Oct.
Metastatic spinal pheochromocytoma (MSP) is very rare in clinical practice, with only a few case reports in the literature. Its low incidence makes it profoundly difficult for clinicians to determine appropriate treatment strategies and predict the prognosis. In this study, we analyzed the clinical characteristics, surgical procedure and prognosis of patients with MSP in one of the largest clinical investigations of this entity to date.
In this study, we conducted a retrospective analysis of the clinical data of 10 patients with MSP who were treated in our department from 2012 to 2020. We performed a total of 14 operations using two types of surgery: open surgery and percutaneous vertebroplasty.
Among them, nine patients underwent 14 spinal operations with satisfactory effect and without any perioperative complications. The mean time from the initial operation to detection of spinal metastasis was 85.3 (12-132) months. The average follow-up time was 27.3 months. Disease progression was detected in nine patients, and eight patients (80%) died during the follow-up period. Univariate analysis showed that extraosseous visceral metastasis ( = 0.022), Tomita score ( = 0.027), and number of spinal metastases ( = 0.024) were associated with overall survival (OS). In addition, extraosseous visceral metastasis ( = 0.030), Tomita score ( = 0.013), and number of spinal metastases ( = 0.026) were associated with progression-free survival (PFS).
Surgical treatment is an effective option in treating MSP and plays an important role in improving patients' quality of life, due to its efficacy in relieving pain, reconstruction of stability, and restoration of function. Extraosseous metastasis, Tomita score, and number of spinal metastases are all potential prognostic factors for OS and PFS.
转移性脊柱嗜铬细胞瘤（MSP）在临床实践中非常罕见，文献中仅有少数病例报告。其低发病率使得临床医生很难确定合适的治疗策略并预测预后。在本研究中，我们在迄今为止关于该疾病的最大规模临床调查之一中，分析了MSP患者的临床特征、手术方法及预后。
在本研究中，我们对2012年至2020年在我科接受治疗的10例MSP患者的临床资料进行了回顾性分析。我们使用两种手术方式共进行了14次手术：开放手术和经皮椎体成形术。
其中，9例患者接受了14次脊柱手术，效果满意，且无任何围手术期并发症。从初次手术到发现脊柱转移的平均时间为85.3（12 - 132）个月。平均随访时间为27.3个月。9例患者出现疾病进展，8例患者（80%）在随访期间死亡。单因素分析显示，骨外内脏转移（P = 0.022）、Tomita评分（P = 0.027）和脊柱转移灶数量（P = 0.024）与总生存期（OS）相关。此外，骨外内脏转移（P = 0.030）、Tomita评分（P = 0.013）和脊柱转移灶数量（P = 0.026）与无进展生存期（PFS）相关。
手术治疗是治疗MSP的有效选择，因其在缓解疼痛、重建稳定性和恢复功能方面的疗效，对提高患者生活质量具有重要作用。骨外转移、Tomita评分和脊柱转移灶数量均是OS和PFS的潜在预后因素。
