A single-center 10-year retrospective study of clinical features and surgical treatment of spinal metastasis from cholangiocarcinoma

Ann Palliat Med. 2021 Feb;10(2):1825-1833. doi: 10.21037/apm-20-1576. Epub 2020 Dec 11.

Abstract

Background: This study intends to discuss the clinical features, therapeutic strategies, and patients' prognostic features and to share our expertise in handling this entity. Current research is one of Asia's extensive MSCCA clinical studies until now.

Methods: Four MSCCA patients who were operated in our hospital's bone tumor center from January 2010 to January 2020 were chosen. Our team reviewed a retrospective study of the medical history and records of surgery, imaging data, and pathology reports (both primary and metastatic spinal tumors) of all MSCCA patients. We applied two surgical therapies in this study, including open surgery and percutaneous vertebroplasty. A predetermined analysis of patients' original clinical data was performed, and regular followup was performed after the operation.

Results: Of the four patients, one was male and three were female. The age ranged from 60 to 70 years. The time duration between the diagnosis of cholangiocarcinoma (CCA) and the diagnosis of spinal metastases ranged from 0 to 11 months. Spinal metastatic disease was mainly located in the thoracic spine (n=4; 100%), followed by the cervical spine (n=1; 25.0%). Postoperatively, in the four patients, the symptoms improved and the VAS score was decreased. During the follow-up visit, the progression of the local spinal tumors at the site of primary spinal surgery was detected in three patients (75.0%). Three patients died from the disease during the follow-up period, and one patient is still alive. The time ranged from 6 to 13 months for spinal surgery to the patient's death.

Conclusions: Taken together, the prognosis of patients with MSCCA is poor. Surgical treatment can dramatically improve patients' quality of life and helps to extend a patient's survival. In terms of surgical treatment, appropriate surgical treatment should be selected according to the general condition of the patient and the relevant characteristics of spinal metastases.

Keywords: Cholangiocarcinoma (CCA); clinical features; open surgery; percutaneous vertebroplasty; prognosis; spinal metastases; surgical treatment.

MeSH terms

  • Aged
  • Cholangiocarcinoma* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Spinal Neoplasms* / surgery
  • Treatment Outcome