Metastatic lesion of the spine due to renal cell carcinoma: outcomes and survival after tumor resection

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Objective. To evaluate the impact of surgical intervention and targeted therapy on the results of treatment and survival of patients with metastases of renal cell carcinoma to the spine. Material and Methods . Retrospective analysis of 100 patients (76 men, 24 women, mean age 58.4 years) with renal cell carcinoma metastases to the spine was carried out. Metastasectomy (en block resection) was performed in 39 patients, palliative decompression and stabilization — in 61. Twenty six patients received adjuvant targeted therapy (7 with metastasectomy, 19 with palliative decompression). The pain syndrome (VAS), neurological status (Frankel scale), and survival time (from the moment of surgery till the lethal outcome or the last follow-up examination) were assessed. The Kaplan – Meier survival analysis and Log-rank test were performed. A p-value < 0.05 was considered significant. Results . All patients demonstrated restoration of neurologic function and reduction of pain syndrome. There was no significant difference in survival time in patients with metastasectomy and palliative decompression (p = 0.47). Statistically significant survival benefit was observed in patients who underwent targeted therapy (p = 0.0019). Conclusion . Targeted therapy increases survival time in patients with renal cell carcinoma metastases to the spine. Metastasectomy is advisable with additional targeted therapy.