4.2 Article

Clinical characteristics and surgical treatment of spinal metastases from pancreatic cancer: a single-center retrospective study

Journal

ANNALS OF PALLIATIVE MEDICINE
Volume 10, Issue 2, Pages 1276-1284

Publisher

AME PUBLISHING COMPANY
DOI: 10.21037/apm-20-1168

Keywords

Pancreatic cancer; spinal metastasis; surgical treatment; percutaneous vertebroplasty; adjuvant therapy; prognosis

Funding

  1. Peking Union Medical College Graduate Student Innovation Fund (2018) [2018-1002-02-08]

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This study reviewed four rare cases of pancreatic cancer spinal metastases and found that all patients died of pancreatic cancer during follow-up visits, with a shorter survival time and a poor prognosis.
Background: To improve the understanding of the characteristics of rare pancreatic cancer spinal metastatic disease and share our experience in coping with this disease. Although spinal metastasis of pancreatic cancer is extremely rare clinically, and the prognosis of the primary tumor is very poor, pancreatic cancer spinal metastasis has received insufficient attention in clinical practice and is only described in a limited number of case reports or series. The purpose of the present study is to discuss the clinical features, prognostic characteristics, and treatment of individuals with pancreatic cancer spinal metastases. Methods: Four patients with clinical symptoms caused by metastatic spinal pancreatic cancer (MSPC) were selected from patients treated in our department between January 2010 and January 2020. Patients' clinical and surgical records, imaging data, and pathology reports were reviewed by our team. A retrospective analysis of patient clinical data was conducted. Results: Of the four patients, one was male and three were female. The average age was 68.0 (range, 61-79) years old. The average time between the pancreatic cancer diagnosis and the diagnosis of spinal metastases was 10.5 (range, 0-24) months. Spinal metastatic disease was primarily found in the thoracic spine (n=3; 75.0%), and the lumbar spine (n=2; 50.0%). During follow-up, local tumor progression was found in all four patients (100%), all of whom died of pancreatic cancer during follow-up visits. The median time between spinal surgery and death was 16.3 (range, 12-19) months. Conclusions: Taken together, pancreatic cancer patient that have spinal metastases exhibit a poor prognosis, with a survival time shorter than for any other malignant tumor. Percutaneous vertebroplasty may become an effective treatment option for pancreatic cancer spinal metastasis, which can significantly improve the patient's symptoms.

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