Post-Doctoral Neurosurgery Research Fellow Johns Hopkins University Johns Hopkins University School of Medicine Baltimore, MD, US
Disclosure(s):
Abdel-Hameed Al-Mistarehi, MD: No financial relationships to disclose
Introduction: Colorectal cancer (CRC), a leading cause of cancer-related deaths, has an increasing incidence of spinal metastases. These cases often have poor prognoses, with limited research on clinical characteristics and predictors of survival in CRC patients with spinal metastases. This study evaluates the clinical and pathological factors affecting treatment outcomes and survival in these patients.
Methods: We conducted a retrospective cohort study of 27 patients treated at Johns Hopkins Medical Institutes with CRC-derived spinal metastases. Demographics, biomarker profiles, surgical outcomes, and survival data were collected. Neurological function was evaluated pre- and post-surgery using Frankel scores. Survival outcomes included overall survival (OS), time to spinal metastasis, and survival post-metastasis (SPM). Statistical analyses were performed using Kaplan-Meier curves, with a p-value threshold 0.05 for significance.
Results: The median patient age was 58 years, with 63% female. The sacral spine was the most frequently involved (59.3%), followed by the thoracic and lumbar regions. Nearly 89% of patients had extraspinal metastases, predominantly in the lungs. Biomarker analysis revealed microsatellite stability (63%) and CDX-2 expression (37%) as the most common findings. Most patients (85%) underwent vertebrectomy, postoperatively improving both ambulatory function and neurological outcomes. The median OS was 4.9 years, while the SPM was 3.0 years. Univariable analysis indicated that CK-20 expression and spinal tumor recurrence were significantly associated with decreased SPM (p = 0.041 and p = 0.045, respectively).
Conclusion : This study highlights the prognostic impact of CK-20 expression and tumor recurrence on survival in CRC patients with spinal metastases. Surgical intervention contributed to improved neurological outcomes. Further research with larger cohorts is essential to validate these findings and enhance treatment strategies for CRC patients with spinal metastases.
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