
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.118
vdae090.118
Final Category: Spinal Cord Metastases
AcademicSubjects/MED00300
AcademicSubjects/MED00310
SPCM-04 SURGICAL EXCISION OF SPINAL INTRADURAL METASTASES: A 10 YEAR INSTITUTIONAL EXPERIENCE
Ambati Vardhaan UCSF, San Francisco, USA

Patel Arati UCSF, San Francisco, USA

Tawil Michael UCSF, San Francisco, USA

Krishnan Nishanth UCSF, San Francisco, USA

Bernabei John UCSF, San Francisco, USA

Zammar Samer UCSF, San Francisco, USA

Ames Christopher UCSF, San Francisco, USA

Clark Aaron UCSF, San Francisco, USA

Chin Cynthia UCSF, San Francisco, USA

Alan Nima UCSF, San Francisco, USA

Chou Dean Columbia, New York City, USA

Mummaneni Praveen UCSF, San Francisco, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i35i36
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

INTRODUCTION)

Spinal intradural metastases are rare and are usually managed non-operatively given poor prognosis of widespread metastatic disease. Surgical resection is considered in cases of rapid, progressive neurological decline. We describe our single-center, 10-year experience of surgical resection of spinal intradural metastases.

METHODS)

Adults who underwent surgical resection of spinal intradural metastatic (excluding neurogenic) tumors at a single quaternary care institution over 10 years were reviewed. Clinical, surgical, and postoperative outcomes were summarized.

RESULTS)

Twelve patients (5 female) with mean age 58.3 (range 32.5-77.6) years underwent resection of spinal intradural metastases (5 intramedullary, 7 extramedullary). Cases included metastatic adenocarcinoma (2 breast, 1 parotid, 1 uterine), melanoma (3), renal cell carcinoma (2), follicular thyroid carcinoma (1), adenoid cystic carcinoma (1), and prostate cancer (1). Tumors were located at thoracolumbar junction (6), cervicothoracic junction (3), lumbar (2), and cervical spine (1). Patients presented with mean 9.4 weeks (range 1-day to 1-year) of symptoms. At presentation, 9 were found to have leptomeningeal disease; 6 had brain metastases. All patients underwent laminectomy (median 3; range 2-5 levels). Gross total resection of symptom-causing tumors was achieved in 5 of 12 patients. Postoperatively, 11 patients demonstrated stable/improving neurological exams from preoperative baseline. Ninety-day readmission rate was 50%, and two patients required reoperation for pseudomeningocele. Eleven patients were treated with neoadjuvant/adjuvant therapy (TKIs, hormonal, immunotherapy). Six underwent radiation therapy. Mean follow-up was 1.2 years, at which point, 3 patients died (mean survival 2-years, range 1month-4.9years). Mean cohort Karnofsky Performance Scale (KPS) improved from 44% preoperatively (range 30-70%) to 53% (range 0% [deceased]-90%); mean KPS improves to 64% if deceased patients are excluded.

CONCLUSION)

This represents one of the largest series of surgically treated intradural nonneurogenic metastases. Even in patients with widespread metastatic burden, intradural tumor resection in patients with neurological decline may improve postoperative function and survival.
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