Spinal Metastases from Colorectal Cancer at Mass General Brigham: A Twenty-Year Case Series with Literature Review

Authors

Alexander G. Yearley, Harvard Medical School, Boston, MA, 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02115, USA. Electronic address: alexander_yearley@hms.harvard.edu.
Jack J. McNulty, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA; Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
Eric J. Chalif, George Washington University, School of Medicine and Health Sciences, Washington, D.C. 20052, USA.
Joshua I. Chalif, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Suk Joon Lee, Harvard Medical School, Boston, MA, 02115, USA; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, 02114, USA.
Neil Klinger, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Hasan A. Zaidi, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02115, USA. Electronic address: hzaidi1@bwh.harvard.edu.

Document Type

Journal Article

Publication Date

5-17-2023

Journal

World neurosurgery

DOI

10.1016/j.wneu.2023.05.045

Keywords

case series; colorectal cancer; neurosurgery; spinal metastasis

Abstract

OBJECTIVE: We present an institutional case series of patients treated for colorectal carcinoma (CRC) spinal metastases to investigate the outcomes between no treatment, radiation, surgery, and surgery/radiation. METHODS: A retrospective cohort of patients with CRC spinal metastases presenting to affiliated institutions between 2001 and 2021 was identified. Information related to patient demographics, treatment modality, treatment outcomes, symptom improvement, and survival was collected by chart review. Overall survival (OS) was compared between treatments by log-rank significance testing. A literature review was conducted to identify other cases series of CRC patients with spinal metastases. RESULTS: Eighty-nine patients (mean age 58.5) with CRC spinal metastases across a mean of 3.3 levels met inclusion criteria: 14 (15.7%) received no treatment, 11 (12.4%) received surgery alone, 37 (41.6%) received radiation alone, and 27 (30.3%) received both radiation and surgery. Patients treated with combination therapy had the longest median OS of 24.7 months (range 0.6-85.9), which did not significantly differ from the median OS of 8.9 months (range 0.2-42.6) observed in patients who received no treatment (p = 0.075). Combination therapy provided objectively longer survival time in comparison to other treatment modalities but failed to reach statistical significance. The majority of patients that received treatment (n = 51/75, 68.0%) experienced some degree of symptomatic or functional improvement. CONCLUSION: Therapeutic intervention has the potential to improve the quality of life in patients with CRC spinal metastases. We demonstrate that surgery and radiation are useful options for these patients, despite their lack of objective improvement in OS.

APA Citation

Yearley, Alexander G.; McNulty, Jack J.; Chalif, Eric J.; Chalif, Joshua I.; Lee, Suk Joon; Klinger, Neil; and Zaidi, Hasan A., "Spinal Metastases from Colorectal Cancer at Mass General Brigham: A Twenty-Year Case Series with Literature Review" (2023). GW Authored Works. Paper 2889.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2889

Department

School of Medicine and Health Sciences Student Works