Influence of the type of neoplasm and treatment on the survival of patients with malignant spinal tumours.

INTRODUCTION The skeletal system is the third most frequent (after lungs and liver) seat of metastases, and metastatic tumours are the most common type of bone malignancies. The aim of the study was to evaluate the influence of the type of neoplasm and method of treatment on the survival of patients with malignant spinal tumours. MATERIALS AND METHODS A retrospective analysis of 452 patients operated on between 2000 and 2004 in the Orthopaedic Surgery Hospital in Piekary Slaskie revealed a group of 203 patients whose histopathologic examination confirmed the presence of neoplastic foci in the spine. Data concerning the type of surgery and tumour location in 139 patients with the most frequent malignant spinal tumors were analyzed. The other information concerning subsequent treatment was analyzed in the Maria Skłodowska-Curie Oncology Centre and Institute in Gliwice. Patient deaths were verified in the Regional Administrative Office in Katowice. RESULTS The most common types of neoplasms producing spinal metastases (in patients who underwent surgery) were: breast cancer, prostatic adenocarcinoma and kidney cancer. Multiple myeloma was the most frequent diagnosis among primary bone neoplasms. The survival of patients with multiple myeloma was statistically longer than the survival of patients with renal, breast and prostatic cancer metastases. It appears that, in the absence of contraindications, the best treatment for patients with spinal metastases is locally radical surgery combined with radiation therapy (a single teleradiotherapy session of 8 Gy). This treatment resulted in a statistically significant prolongation of life of the patients. CONCLUSIONS The length of survival of patients with malignant spinal metastases is influenced by the type of neoplasm and locally radical surgery combined with palliative radiation therapy.