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转移性乳腺癌脊柱手术后的短期疗效:单中心分析

Short-term outcomes after spinal surgery for metastatic breast cancer: A single-center analysis.

作者信息

Gomes Nicole Iafigliola, de Almeida Rômulo Augusto Andrade, Joaquim Andrei Fernandes

机构信息

Medical Student, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.

Department of Neurosurgery, MD Anderson Cancer Center, Houston, TX, USA.

出版信息

J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):284-289. doi: 10.4103/jcvjs.jcvjs_59_24. Epub 2024 Sep 12.

Abstract

BACKGROUND

Advances in detection and breast cancer treatment lead to higher survival rates, with more patients living with spine metastases. Those surgeries are palliative; however, they can improve the quality of life (QOL).

OBJECTIVE

The aim of this study is to report pain and neurological function outcomes after surgery for spinal metastatic disease of breast cancer patients of a single institution. Complications were recorded.

MATERIALS AND METHODS

A retrospective, single-center, single-arm study was performed. Consecutive patients who underwent spinal surgery were included. We analyzed demographic, surgical, histopathological, and clinical data.

RESULTS

Seventeen women were included. Three patients (17.6%) did not present pre- and postoperative pain (n = 3), 6 (35.3%) had pain in both situations, and 8 (47.1%) were pain-free postoperatively (P = 0.013). Ten (58.8%) patients had preoperative deficits: 3 (30%) did not improve and 7 (70%) improved after surgery. Six cases (35.2%) did not present preoperative deficits and did not get worse (n = 6). The Frankel classification after the following time showed that 11 patients (64.7%) remained stable after surgery and 5 patients (29.4%) got better. A single patient (5.6%) had deterioration of strength. Two patients (11.7%) had intraoperative complications.

CONCLUSIONS

Pain was significantly improved by surgery, with also a possibly positive effect on functionality. Considering the low complication rates, surgery is still a useful tool in the management of spinal metastases in breast cancer patients and may be related to better QOL.

摘要

背景

检测和乳腺癌治疗方面的进展使生存率提高,更多患者伴有脊柱转移瘤存活。这些手术是姑息性的;然而,它们可以改善生活质量(QOL)。

目的

本研究的目的是报告单一机构中乳腺癌患者脊柱转移性疾病手术后的疼痛和神经功能结果。记录并发症情况。

材料与方法

进行了一项回顾性、单中心、单臂研究。纳入接受脊柱手术的连续患者。我们分析了人口统计学、手术、组织病理学和临床数据。

结果

纳入17名女性。3名患者(17.6%)术前和术后均无疼痛(n = 3),6名(35.3%)在两种情况下均有疼痛,8名(47.1%)术后无疼痛(P = 0.013)。10名(58.8%)患者术前有神经功能缺损:3名(30%)术后未改善,7名(70%)术后改善。6例(35.2%)术前无神经功能缺损且未恶化(n = 6)。术后随访时的Frankel分级显示,11名患者(64.7%)术后保持稳定,5名患者(29.4%)情况好转。1名患者(5.6%)肌力下降。2名患者(11.7%)发生术中并发症。

结论

手术可显著改善疼痛,对功能也可能有积极影响。考虑到并发症发生率较低,手术仍是乳腺癌患者脊柱转移瘤管理中的一种有用工具,且可能与更好的生活质量相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f25/11524564/640097a707c7/JCVJS-15-284-g001.jpg

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