@article{39563ef70f2942e3a13cea4694d214ee,
title = "The Challenges of Renal Cell Carcinoma Metastatic to the Spine: A Systematic Review of Survival and Treatment",
abstract = "Study Design: Systematic review. Objectives: The objective of this systematic review was to answer 2 key questions: (1) What is the clinical presentation and probability of symptomatic improvement following treatment for patients with renal cell carcinoma (RCC) of the spine? (2) What is the overall survival of patients diagnosed with spinal metastases from RCC? Methods: A literature review was performed to identify articles that reported on survival, clinical outcomes, and/or prognostic factors in the RCC population with spinal metastases from 1986 to 2016. Results: Forty-eight articles (807 patients) were included. The Fuhrman Nuclear Grade has been significantly associated with survival in previous studies but was underpowered in the current study. The Memorial Sloan-Kettering Cancer Center Score (MSKCC/Motzer) was also underpowered in the current study. From the time of spinal metastasis, the mean and median survival for patients with previously diagnosed primary RCC was 8.75 and 11.7 months, respectively, whereas synchronously diagnosed patients (primary RCC and spinal metastasis) had a mean and median survival of 6.75 and 11 months, respectively. Patients with a “low” (0-8), “intermediate” (9-11), or “high” (12-15) revised Tokuhashi score at initial presentation had a median survival of 5.4, 11.7, and 32.9 months, respectively. Conclusion: Patients with either a synchronous or latent diagnosis of RCC survived greater than 6 months from the time of presentation. Initial Furhman grade, Tokuhashi score, and MSKCC/Motzer can be useful tools in informing patient-specific prognosis for those with metastatic RCC of the spine.",
keywords = "Tokuhashi score, kidney cancer, radiation therapy, renal cell carcinoma, spine metastasis, survival, tumor",
author = "Goodwin, {C. Rory} and Ahmed, {A. Karim} and Christine Boone and Nancy Abu-Bonsrah and Risheng Xu and Niccole Germscheid and Fourney, {Daryl R.} and Michelle Clarke and Ilya Laufer and Fisher, {Charles G.} and Chetan Bettegowda and Sciubba, {Daniel M.}",
note = "Funding Information: Carrie Price, MLS, for technical assistance with search criteria. This work received support from the AOSpine Knowledge Forum Tumor. AOSpine is a clinical division of the AO Foundation—an independent medically guided nonprofit organization. The AOSpine Knowledge Forums are pathology-focused working groups acting on behalf of AOSpine in their domain of scientific expertise. Each forum consists of a steering committee of up to 10 international spine experts who meet on a regular basis to discuss research, assess the best evidence for current practices, and formulate clinical studies to advance spine care worldwide. Study support is provided directly through AOSpine{\textquoteright}s Research department. Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: C. Rory Goodwin: UNCF Merck Postdoctoral Fellow and has received an award from the Burroughs Wellcome Fund and the Johns Hopkins Neurosurgery Pain Research Institute. A. Karim Ahmed: has received an award from the NREF Medical Student Summer Research Fellowship. Ilya Laufer: Globus, SpineWave, Depuy/Synthes, Med-tronic, BrainLab. Charles G. Fisher: Royalties from Medtronic, consulting for Medtronic and Nuvasive, and research support from OREF, AOSpine, and Medtronic. Daniel M. Sciubba: consultant for Medtro-nic, Globus, DePuy, and Stryker. The remaining authors have no conflicts of interest to disclose. Publisher Copyright: {\textcopyright} The Author(s) 2017.",
year = "2018",
month = aug,
day = "1",
doi = "10.1177/2192568217737777",
language = "English (US)",
volume = "8",
pages = "517--526",
journal = "Global Spine Journal",
issn = "2192-5682",
publisher = "Thieme Medical Publishers",
number = "5",
}