전립선 암으로 인한 전이성 척추종양 노인 환자 18명의 수술적 치료 결과

초록

Objective The standard for classifying metastatic spinal tumor patients with prostate cancer who can benefit from surgery is not clear. Therefore, we evaluated elderly patients with prostate cancer who underwent spine surgery for metastatic lesion to estimate outcome of surgery and to find predictors of better outcome. Methods Methods Between January 2008 and December 2015, we collected data of 18 consecutive elderly patients with prostate cancer who underwent spine surgery for metastatic lesion at a single institution. Operations were performed for patients who had severe pain or neurological deficits due to thecal sac and nerve roots compression. Thirteen patients had hormone-refractory prostate cancer, and 5 patients had hormone-naïve prostate cancer which were previously untreated. Ten patients had posterior approach decompression surgery only, and 8 patients had posterior approach decompression and also additional stabilization. Results Four hormone-naïve patients and 2 hormone-refractory patients who suffered from severe pain preoperatively showed decreasing of pain postoperatively (p=0.009). Five patients with Karnofsky performance status scale ≥70% showed decreasing of pain postoperatively (p=0.006), and 5 patients who had no visceral metastases showed decreasing of pain postoperatively (p=0.046). One patient who was unable to walking preoperatively became able to walk with walking frame postoperatively. While another one became unable to walk postoperatively, 4 of 18 patients including the latter showed worse American Spinal Injury Association impairment scale postoperatively either. Conclusion Conclusion Patients with hormone-naïve prostate cancer, and those with good performance status and lacking of visceral metastases, can have better outcome and prognosis by spine surgery for metastatic lesion.