Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review
Introduction: Spinal metastases (SM) are a frequent complication of cancer and may lead to pathologic vertebral compression fractures (pVCF) and/or metastatic epidural spinal cord compression (MESCC). Based on autopsy studies, it is estimated that about one third of all cancer patients will develop...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of Bone Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137422000367 |
| _version_ | 1798038124071223296 |
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| author | Ruben Van den Brande Erwin MJ Cornips Marc Peeters Piet Ost Charlotte Billiet Erik Van de Kelft |
| author_facet | Ruben Van den Brande Erwin MJ Cornips Marc Peeters Piet Ost Charlotte Billiet Erik Van de Kelft |
| author_sort | Ruben Van den Brande |
| collection | DOAJ |
| description | Introduction: Spinal metastases (SM) are a frequent complication of cancer and may lead to pathologic vertebral compression fractures (pVCF) and/or metastatic epidural spinal cord compression (MESCC). Based on autopsy studies, it is estimated that about one third of all cancer patients will develop SM. These data may not provide a correct estimation of the incidence in clinical practice. Objective: This systematic review (SR) aims to provide a more accurate estimation of the incidence of SM, MESCC and pVCF in a clinical setting. Methods: We performed a SR of papers regarding epidemiology of SM, pVCF, and MESCC in patients with solid tumors conform PRISMA guidelines. A search was conducted in the PubMed and Web of Science database using the terms epidemiology, prevalence, incidence, global burden of disease, cost of disease, spinal metastas*, metastatic epidural spinal cord compression, pathologic fracture, vertebral compression fracture, vertebral metastas* and spinal neoplasms. Papers published between 1975 and august 2021 were included. Quality was evaluated by the STROBE criteria. Results: While 56 studies were included, none of them reports the actual definition used for MESCC and pVCF, inevitably introducing heterogenity. The overall cumulative incidence of SM and MESCC is 15.67% and 2.84% respectively in patients with a solid tumor. We calculated a mean cumulative incidence in patients with SM of 9.56% (95% CI 5.70%-13.42%) for MESCC and 12.63% (95% CI 7.00%-18.25%) for pVCF. Studies show an important delay between onset of symptoms and diagnosis. Conclusions: While the overall cumulative incidence for clinically diagnosed SM in patients with a solid tumor is 15.67%, autopsy studies reveal that SM are present in 30% by the time they die, suggesting underdiagnosing of SM. Approximately 1 out of 10 patients with SM will develop MESCC and another 12.6% will develop a pVCF. Understanding these epidemiologic data, should increase awareness for first symptoms, allowing early diagnosis and subsequent treatment, thus improving overall outcome. |
| first_indexed | 2024-04-11T21:35:56Z |
| format | Article |
| id | doaj.art-84b1e25a7fac42569cbc9d717cae92ce |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-04-11T21:35:56Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-84b1e25a7fac42569cbc9d717cae92ce2022-12-22T04:01:45ZengElsevierJournal of Bone Oncology2212-13742022-08-0135100446Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic reviewRuben Van den Brande0Erwin MJ Cornips1Marc Peeters2Piet Ost3Charlotte Billiet4Erik Van de Kelft5University of Antwerp, Belgium; Department of Neurosurgery, Ziekenhuis Oost Limburg Genk, BelgiumDepartment of Neurosurgery, Ziekenhuis Oost Limburg Genk, BelgiumUniversity of Antwerp, Belgium; Department of Oncology, Antwerp University Hospital, BelgiumIridium Network, Antwerp, Belgium; Department of Radiotherapy, GZA Hospital, Antwerp, BelgiumIridium Network, Antwerp, Belgium; Department of Radiotherapy, GZA Hospital, Antwerp, BelgiumUniversity of Antwerp, Belgium; Department of Neurosurgery, Vitaz Sint-Niklaas, BelgiumIntroduction: Spinal metastases (SM) are a frequent complication of cancer and may lead to pathologic vertebral compression fractures (pVCF) and/or metastatic epidural spinal cord compression (MESCC). Based on autopsy studies, it is estimated that about one third of all cancer patients will develop SM. These data may not provide a correct estimation of the incidence in clinical practice. Objective: This systematic review (SR) aims to provide a more accurate estimation of the incidence of SM, MESCC and pVCF in a clinical setting. Methods: We performed a SR of papers regarding epidemiology of SM, pVCF, and MESCC in patients with solid tumors conform PRISMA guidelines. A search was conducted in the PubMed and Web of Science database using the terms epidemiology, prevalence, incidence, global burden of disease, cost of disease, spinal metastas*, metastatic epidural spinal cord compression, pathologic fracture, vertebral compression fracture, vertebral metastas* and spinal neoplasms. Papers published between 1975 and august 2021 were included. Quality was evaluated by the STROBE criteria. Results: While 56 studies were included, none of them reports the actual definition used for MESCC and pVCF, inevitably introducing heterogenity. The overall cumulative incidence of SM and MESCC is 15.67% and 2.84% respectively in patients with a solid tumor. We calculated a mean cumulative incidence in patients with SM of 9.56% (95% CI 5.70%-13.42%) for MESCC and 12.63% (95% CI 7.00%-18.25%) for pVCF. Studies show an important delay between onset of symptoms and diagnosis. Conclusions: While the overall cumulative incidence for clinically diagnosed SM in patients with a solid tumor is 15.67%, autopsy studies reveal that SM are present in 30% by the time they die, suggesting underdiagnosing of SM. Approximately 1 out of 10 patients with SM will develop MESCC and another 12.6% will develop a pVCF. Understanding these epidemiologic data, should increase awareness for first symptoms, allowing early diagnosis and subsequent treatment, thus improving overall outcome.http://www.sciencedirect.com/science/article/pii/S2212137422000367Spinal metastasesMetastatic epidural spinal cord compressionPathologic vertebral compression fractureOncologyEpidemiology |
| spellingShingle | Ruben Van den Brande Erwin MJ Cornips Marc Peeters Piet Ost Charlotte Billiet Erik Van de Kelft Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review Journal of Bone Oncology Spinal metastases Metastatic epidural spinal cord compression Pathologic vertebral compression fracture Oncology Epidemiology |
| title | Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review |
| title_full | Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review |
| title_fullStr | Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review |
| title_full_unstemmed | Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review |
| title_short | Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review |
| title_sort | epidemiology of spinal metastases metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors a systematic review |
| topic | Spinal metastases Metastatic epidural spinal cord compression Pathologic vertebral compression fracture Oncology Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S2212137422000367 |
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