Characterization of Surgical Treatment and Survivability of Spinal Metastasis from Prostate Cancer

Introduction: The spine represents one of the most common bony sites for metastasis of prostate cancer. This study examines patient survivability, age, race, and surgery type in the treatment for spinal metastasis from prostate cancer.

Methods: Single institution radiology reports from January 2017- December 2021 were queried for spinal metastases. Demographic factors, address, primary cancer type, treatment data, time to treatment, and time of death were obtained for each patient, as applicable. Time to treatment was defined as the number of days elapsed between initial radiographic imaging showing spine metastases and the subsequent treatment. Variables were analyzed using descriptive statistics and comparisons were performed using coefficient of determination analysis or one-way analysis of variance (ANOVA) (p < 0.05).

Results: Initial query resulted in 986 patients with complete treatment information. 119 (12.07%) received spine surgery as a treatment modality, of whom 24 (2.43% of all patients; 20.17% of patients receiving spine surgeries) had prostate cancer as the site of primary tumor. 14 of this group of 24 had a complete date of expiration. The average patient age at diagnosis was 68-years-old, and the average survival time was 424.75 days (SD: 377.70). Data showed no correlation between age and survivability (R-squared: 0.036). 13 (54.17%) of the patients receiving spine surgery for prostate cancer metastasis, and 9 (64.29%) of the patients with complete expiration dates identified as Black of African American; no significant differences were observed in comparing survivability of Black vs. non-Black patients (p=0.55). Of the 24 patients receiving surgery, 19 (79.17%) received multilevel fusions; survivability was not significantly impacted (p=0.85).

Conclusion : Survivability from spinal metastases is complex and cannot easily be explained by primary cancer type, the age of patients at the time of diagnosis, race, or treatment by spinal fusion. More study is necessary to investigate differences in treatment and survivability for spinal metastases.