Surgical Management of Cervical Spine Metastases From Differentiated Thyroid Cancers
Posted: Friday, December 18, 2020
For patients with differentiated thyroid carcinoma, surgical management of cervical spine metastases may improve overall survival and local disease control, according to a study published in The Laryngoscope. Such patients should be referred to orthopedic spine surgeons following diagnosis of their carcinoma, explained Eric J. Moore, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues.
From 2002 to 2018, a total of 50 patients with differentiated thyroid cancer and cervical spine metastases were recruited for the study. Patients were treated with surgical resection of the cervical spine (n = 16) or did not have any surgical intervention (n = 34).
The study findings revealed that patients who received surgical intervention were more likely to have local (P < .01) and systemic (P = .04) disease control as compared with patients who did not. In addition, patients who underwent surgical resection were more likely to report a subjective improvement in their symptoms (P < .01). Moreover, the overall 5-year survival rate reported was 44.7% in the group that had surgery, as compared with 11.1% for the group that did not.
Furthermore, 74% of patients reported neck pain as their presenting symptom. The risk factor most indicative for improved overall survival was local disease control at the cervical spine (hazard ratio = 0.32). Overall, the study authors concluded that surgical intervention was positively associated with improved survival through univariate (hazard ratio = 0.35) and multivariate (hazard ratio = 0.37) analyses.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.