Abstract
BackgroundAdvancements in the field of oncological therapies during the last decades have led to a significantly prolonged survival of cancer patients. This has led to an increase in the incidence of spinal metastases. The purpose of this study was to assess risk factors for wound-related complications after surgical stabilization of spinal metastases with a special focus on the effect of postoperative RT and its timing.MethodsPatients who had been treated for metastatic spine disease by surgical stabilization followed by radiotherapy between 01/2012 and 03/2019 were included and a retrospective chart review was performed.ResultsOf 604 patients who underwent stabilizing surgery for spinal metastases, 237 patients (mean age 66 years, SD 11) with a mean follow-up of 11 months (SD 7) were eligible for further analysis. Forty-one patients (17.3%) had wound-related complications, 32 of them before and 9 after beginning of the RT. Revision surgery was necessary in 26 patients (11.0%). Body weight (p = 0.021), obesity (p = 0.018), ASA > 2 (p = 0.001), and start of radiation therapy within 21 days after surgery (p = 0.047) were associated with an increased risk for wound complications. Patients with chemotherapy within 3 weeks of surgery (12%) were more likely to have a wound-related surgical revision (p = 0.031).ConclusionBody weight, obesity and ASA > 2 were associated with an increased risk for wound complications. Patients with chemotherapy within 3 weeks of the surgery were more likely to have a wound-related revision surgery. Patients who had begun radiation therapy within 21 days after surgery were more likely to have a wound complication compared to patients who waited longer.
Highlights
Advancements in the field of oncological therapies during the last decades have led to a significantly prolonged survival of cancer patients
Patients who had received chemotherapy within 3 weeks of the surgery (29/237, 12%) were more likely to have a woundrelated revision surgery compared to patients who were not under chemotherapy (22% vs. 9%, p = 0.031)
Kumar et al included all kind of patients with metastatic spine tumors while the present study focused on patients who received surgery and RT
Summary
Advancements in the field of oncological therapies during the last decades have led to a significantly prolonged survival of cancer patients. This has led to an increase in the incidence of spinal metastases. The progress and innovations in the field of oncological therapies during the last decades have led to a significantly prolonged survival of cancer patients. Jarvers et al BMC Surgery (2021) 21:423 spinal cord compression as a complication of metastatic spine disease (MSD) occurs in at least 10% of these patients [1, 2]. Even in the setting neurological deficits due to MSD, a combined approach showed better results compared to RT alone [4]. Better patient survival and cost savings were demonstrated throughout the treatment period [5, 6]
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