Nevzati Edin, Poletti Nicolas, Spiessberger Alexander, Bäbler Sabrina, Studer Gabriela, Riklin Christian, Diebold Joachim, Chatain Grégoire P, Finn Michael, Witt Jens-Peter, Moser Manuel, Mariani Luigi
Department of Neurosurgery, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
Department of Spine Surgery, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
Front Surg. 2023 Jul 28;10:1222595. doi: 10.3389/fsurg.2023.1222595. eCollection 2023.
Tumors of the vertebral column consist of primary spinal tumors and malignancies metastasizing to the spine. Although primary spine tumors are rare, metastases to the spine have gradually increased over past decades because of aging populations and improved survival for various cancer subtypes achieved by advances in cancer therapy. Metastases to the vertebral column occur in up to 70% of cancer patients, with 10% of patients demonstrating epidural spinal cord compression. Therefore, many cancer patients may face spinal surgical intervention during their chronic illness; such interventions range from simple cement augmentation over decompression of neural elements to extended instrumentation or spinal reconstruction. However, precise surgical treatment guidelines do not exist, likely due to the lack of robust, long-term clinical outcomes data and the overall heterogeneous nature of spinal tumors. Objectives of launching the Swiss Spinal Tumor Registry (Swiss-STR) are to collect and analyze high-quality, prospective, observational data on treatment patterns, clinical outcomes, and health-related quality of life (HRQoL) in adult patients undergoing spinal tumor surgery. This narrative review discusses our rationale and process of establishing this spinal cancer registry.
A REDCap-based registry was created for the standardized collection of clinical, radiographic, surgical, histological, radio-oncologial and oncological variables, as well as patient-reported outcome measures (PROMs).
We propose that the Swiss-STR will inform on the effectiveness of current practices in spinal oncology and their impact on patient outcomes. Furthermore, the registry will enable better categorization of the various clinical presentations of spinal tumors, thereby facilitating treatment recommendations, defining the socio-economic burden on the healthcare system, and improving the quality of care. In cases of rare tumors, the multi-center data pooling will fill significant data gaps to yield better understanding of these entities. Finally, our two-step approach first implements a high-quality registry with efficient electronic data capture strategies across hospital sites in Switzerland, and second follows with potential to expand internationally, thus fostering future international scientific collaboration to further push the envelope in cancer research.
脊柱肿瘤包括原发性脊柱肿瘤和转移至脊柱的恶性肿瘤。虽然原发性脊柱肿瘤较为罕见,但由于人口老龄化以及癌症治疗进展使各种癌症亚型的生存率提高,过去几十年来脊柱转移瘤的发生率逐渐上升。脊柱转移瘤在高达70%的癌症患者中出现,其中10%的患者出现硬膜外脊髓压迫。因此,许多癌症患者在慢性病过程中可能面临脊柱外科干预;此类干预范围从简单的骨水泥强化到神经减压,再到广泛的内固定或脊柱重建。然而,由于缺乏有力的长期临床结局数据以及脊柱肿瘤的整体异质性,不存在精确的手术治疗指南。启动瑞士脊柱肿瘤登记处(Swiss-STR)的目的是收集和分析接受脊柱肿瘤手术的成年患者在治疗模式、临床结局和健康相关生活质量(HRQoL)方面的高质量、前瞻性观察数据。本叙述性综述讨论了建立该脊柱癌症登记处的基本原理和过程。
创建了一个基于REDCap的登记处,用于标准化收集临床、影像学、手术、组织学、放射肿瘤学和肿瘤学变量,以及患者报告的结局指标(PROMs)。
我们认为,Swiss-STR将为脊柱肿瘤学当前实践的有效性及其对患者结局的影响提供信息。此外,该登记处将使脊柱肿瘤的各种临床表现能够得到更好的分类,从而便于提出治疗建议,确定医疗保健系统的社会经济负担,并提高护理质量。对于罕见肿瘤,多中心数据汇总将填补重大数据空白,以便更好地了解这些实体。最后,我们的两步法首先在瑞士各医院实施一个采用高效电子数据捕获策略的高质量登记处,其次有在国际上扩展的潜力,从而促进未来的国际科学合作,进一步推动癌症研究的发展。