Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):264-268.
Published online September 30, 2016.
Outcome of Surgical Treatment for Metastatic Spinal Tumor in 18 Elderly Patients with Prostate Cancer
Jinsol Han , Se-Hoon Kim , Sung-Won Jin , Seung-Hwan Lee , Bum-Joon Kim , Sang-Dae Kim , Dong-Jun Lim
Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
전립선 암으로 인한 전이성 척추종양 노인 환자 18명의 수술적 치료 결과
한진솔·김세훈·진성원·이승환·김범준·김상대·임동준
고려대학교 의과대학 안산병원 신경외과학교실
Abstract
Objective
The standard for classifying metastatic spinal tumor patients with prostate cancer who can benefit from surgery is not clear. Therefore, we evaluated elderly patients with prostate cancer who underwent spine surgery for metastatic lesion to estimate outcome of surgery and to find predictors of better outcome.
Methods
Methods Between January 2008 and December 2015, we collected data of 18 consecutive elderly patients with prostate cancer who underwent spine surgery for metastatic lesion at a single institution. Operations were performed for patients who had severe pain or neurological deficits due to thecal sac and nerve roots compression. Thirteen patients had hormone-refractory prostate cancer, and 5 patients had hormone-naïve prostate cancer which were previously untreated. Ten patients had posterior approach decompression surgery only, and 8 patients had posterior approach decompression and also additional stabilization.
Results
Four hormone-naïve patients and 2 hormone-refractory patients who suffered from severe pain preoperatively showed decreasing of pain postoperatively (p=0.009). Five patients with Karnofsky performance status scale ≥70% showed decreasing of pain postoperatively (p=0.006), and 5 patients who had no visceral metastases showed decreasing of pain postoperatively (p=0.046). One patient who was unable to walking preoperatively became able to walk with walking frame postoperatively. While another one became unable to walk postoperatively, 4 of 18 patients including the latter showed worse American Spinal Injury Association impairment scale postoperatively either.
Conclusion
Conclusion Patients with hormone-naïve prostate cancer, and those with good performance status and lacking of visceral metastases, can have better outcome and prognosis by spine surgery for metastatic lesion.
Key Words: Elderly, Prostate cancer, Metastasis, Spine surgery


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