Metastatic Spine Tumor Epidemiology: Comparison of Trends in Surgery Across Two Decades and Three Continents

Ernest Wright, Federico Ricciardi, Mark Arts, Jacob M. Buchowski, Chun Kee Chung, Maarten Coppes, Alan Crockard, Bart Depreitere, Michael Fehlings, Norio Kawahara, Chong Suh Lee, Yee Leung, Antonio Martin-Benlloch, Eric Massicotte, Christian Mazel, Cumhur Oner, Wilco Peul, Nasir Quraishi, Yasuaki Tokuhashi, Katsuro TomitaChristian Ulbricht, Jorrit Jan Verlaan, Mike Wang, David Choi

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: Indications for surgery for symptomatic spinal metastases have become better defined in recent years, and suitable outcome measures have been established against a changing backdrop of patient characteristics, tumor behavior, and oncologic treatments. Nonetheless, variations still exist in the local management of patients with spinal metastases. In this study, we aimed to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and to examine how these have changed over the last 25 years. Methods: In this cohort study of consecutive patients undergoing surgery for symptomatic spinal metastases, data were collected using a secure Internet database from 22 centers across 3 continents. All patients were invited to participate in the study, except those unable or unwilling to give consent. Results: There was a higher incidence of colonic, liver, and lung carcinoma metastases in Asian countries, and more frequent presentation of breast, prostate, melanoma metastases in the West. Trends in surgical technique were broadly similar across the centers. Overall survival rates after surgery were 53% at 1 year, 31% at 2 years, and 10% at 5 years after surgery (standard error 0.013 for all). Survival improved over successive time periods, with longer survival in patients who underwent surgery in 2011–2016 compared with those who underwent surgery in earlier time periods. Conclusions: Surgical habits have been fairly consistent among countries worldwide and over time. However, patient survival has improved in later years, perhaps due to medical advances in the treatment of cancer, improved patient selection, and operating earlier in the course of disease.

Original languageEnglish (US)
Pages (from-to)e809-e817
JournalWorld neurosurgery
StatePublished - Jun 2018
Externally publishedYes


  • Epidemiology
  • Metastases
  • Spine
  • Surgery
  • Tumor

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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