Perioperative Complications and Prognosis of Curative Surgical Resection for Spinal Metastases in Elderly Patients

• Published in: World neurosurgery Vol. 137; pp. e144 - e151
• Main Authors: Yonezawa, Noritaka, Murakami, Hideki, Demura, Satoru, Kato, Satoshi, Yoshioka, Katsuhito, Shinmura, Kazuya, Yokogawa, Noriaki, Shimizu, Takaki, Oku, Norihiro, Kitagawa, Ryo, Handa, Makoto, Annen, Ryohei, Kurokawa, Yuki, Tsuchiya, Hiroyuki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2020
• Subjects: Complication; Corpectomy; Elderly patients; Hemivertebrectomy; Spinal metastasis; Spondylectomy; Survival analysis; Spinal metastasis; Survival analysis; TES; OS; CSF; FEV 1.0; Corpectomy; Complication; Spondylectomy; SM; Elderly patients; Hemivertebrectomy
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2020.01.093

The purpose of this study was to evaluate perioperative complications and prognosis associated with curative surgical resection, such as total en bloc spondylectomy, for spinal metastases in elderly patients. We retrospectively reviewed 103 consecutive patients who underwent curative surgery between 2010 and 2017 and divided them into group 1 (n = 27, age <50 years), group 2 (n = 47, age ≥50 and <65 years), and group 3 (n = 29, age ≥65 years). Perioperative complication rate and overall survival (OS) after surgery was evaluated. A total of 129 perioperative complications were observed in 76 of 112 surgeries. Among the 3 groups, the total number of complications per person was the highest in group 3, although the difference was not statistically significant. The total number of serious complications per person was the highest in group 3, which was statistically significant. (0.23 vs. 0.51 vs. 0.90; P < 0.05). No significant difference in OS was observed between the groups. In group 3, a significant difference in OS was found between subgroups 1 (renal cell, thyroid, and breast cancer metastasis) and 2 (other primary tumors) (P < 0.01). In group 3, 24 patients (83%) either maintained or had regained their ambulatory capacity at the final follow-up. Elderly patients who underwent curative surgery had significantly more frequent serious postoperative complications than nonelderly patients. Even in patients with advanced age, curative surgical resection can provide favorable prognosis and local control, especially in those with spinal metastases of renal cell and thyroid cancer.