Liu Shuzhong, Zhou Xi, Wang Muchuan, Yao Siyuan, Niu Tong, Gao Chengao, Li Ziquan, Huo Zhen, 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, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
Ann Palliat Med. 2021 Feb;10(2):1825-1833. doi: 10.21037/apm-20-1576. Epub 2020 Dec 11.
This study intends to discuss the clinical features, therapeutic strategies, and patients' prognostic features and to share our expertise in handling this entity. Current research is one of Asia's extensive MSCCA clinical studies until now.
Four MSCCA patients who were operated in our hospital's bone tumor center from January 2010 to January 2020 were chosen. Our team reviewed a retrospective study of the medical history and records of surgery, imaging data, and pathology reports (both primary and metastatic spinal tumors) of all MSCCA patients. We applied two surgical therapies in this study, including open surgery and percutaneous vertebroplasty. A predetermined analysis of patients' original clinical data was performed, and regular followup was performed after the operation.
Of the four patients, one was male and three were female. The age ranged from 60 to 70 years. The time duration between the diagnosis of cholangiocarcinoma (CCA) and the diagnosis of spinal metastases ranged from 0 to 11 months. Spinal metastatic disease was mainly located in the thoracic spine (n=4; 100%), followed by the cervical spine (n=1; 25.0%). Postoperatively, in the four patients, the symptoms improved and the VAS score was decreased. During the follow-up visit, the progression of the local spinal tumors at the site of primary spinal surgery was detected in three patients (75.0%). Three patients died from the disease during the follow-up period, and one patient is still alive. The time ranged from 6 to 13 months for spinal surgery to the patient's death.
Taken together, the prognosis of patients with MSCCA is poor. Surgical treatment can dramatically improve patients' quality of life and helps to extend a patient's survival. In terms of surgical treatment, appropriate surgical treatment should be selected according to the general condition of the patient and the relevant characteristics of spinal metastases.
本研究旨在探讨多节段脊柱胆管癌转移（MSCCA）的临床特征、治疗策略及患者的预后特征，并分享我们处理该疾病的经验。目前的研究是迄今为止亚洲规模较大的MSCCA临床研究之一。
选取2010年1月至2020年1月在我院骨肿瘤中心接受手术的4例MSCCA患者。我们的团队回顾性研究了所有MSCCA患者的病史、手术记录、影像资料和病理报告（包括原发性和转移性脊柱肿瘤）。本研究应用了两种手术治疗方法，包括开放手术和经皮椎体成形术。对患者的原始临床资料进行了预定分析，并在术后进行定期随访。
4例患者中，男性1例，女性3例。年龄在60至70岁之间。胆管癌（CCA）诊断至脊柱转移诊断的时间间隔为0至11个月。脊柱转移瘤主要位于胸椎（n = 4；100%），其次是颈椎（n = 1；25.0%）。术后，4例患者症状均有改善，视觉模拟评分（VAS）降低。随访期间，3例患者（75.0%）在原发性脊柱手术部位出现局部脊柱肿瘤进展。3例患者在随访期间死于该疾病，1例患者仍存活。从脊柱手术到患者死亡的时间为6至13个月。
综上所述，MSCCA患者的预后较差。手术治疗可显著提高患者的生活质量，并有助于延长患者生存期。在手术治疗方面，应根据患者的一般状况和脊柱转移的相关特征选择合适的手术治疗方法。
