An Analysis of Primary Spinal Tumor Incidence, Survival Outcomes, and Metastasis Rates in 3835 Patients: A Retrospective Analysis from a Multicenter Oncology Database
Medical Student Charles E. Schmidt College of Medicine–FAU Boca Raton, FL, US
Introduction: We investigate the incidence, survival outcomes, and metastasis rates among adult patients with primary spinal tumors.
Methods: Primary spine tumor cases diagnosed between 2000 and 2017 were extracted from the SEER research plus program (N=3835). Statistical analyses were run to extrapolate spine tumor epidemiology in Python (Python Software Foundation, Wilmington, DE).
Results: A total of 3,835 cases of spinal cord tumors were analyzed. The 4 most common tumors to occur were ependymomas (49.4%), pilocytic astrocytomas (7.3%), other astrocytomas/astroglial tumors (13.8%), and diffuse large B cell lymphoma (5.6%). For ependymomas with differentiation identified, 15.1% were grade I, 72.9% were grade II, 2.7% were grade III, and 9.3% were grade IV. For pilocytic astrocytomas with differentiation identified, 54.4% were grade I, 38.2% were grade II, 1.5% were grade III, and 5.9% were grade IV. For other astrocytomas/astroglial tumors with differentiation identified, 15.1% were grade I, 43.1% were grade II, 5.1% were grade III, and 36.6% were grade IV.
3045 patients had surgery. 292 patients had radiation after surgery while 6 patients had radiation after surgery. 733 patients (19.1%) of patients had a death related to their cancer diagnosis, with an average survival time of 27.01 months. Other astrocytoma/astroglial tumors (25.5%), glioblastomas (13.2%), ependymomas (12.6%), and diffuse large B cell lymphoma (10.8%) made up the majority of these deaths. The tumor with the highest mortality rate was glioblastomas (80.2%).
For patients where tumor stage was identified, 2514 patients had localized disease, 215 patients had regional disease, and 303 patients had distant metastasis. Diffuse large B cell lymphomas (32.1%) and neuroblastomas (32.9%) had the highest rates of distant metastasis.
Conclusion : Ependymomas were the most common primary spinal tumors, and the majority of the tumors were grade II. There was a mortality rate of 19.1% with an average survival time of 27.01 months. Other astrocytoma/astroglial tumors were the largest contributor to patient deaths, and glioblastomas had the highest mortality rate. Diffuse large B cell lymphomas and neuroblastomas had the highest rate of distant metastasis.