bims-rebome 2026-10-11 papers

Clin Spine Surg. 2026 Oct 05.

Epidemiology and Oncologic Patterns of Cervical Spine Metastases and Primary Tumors.

Samuel W Rice, William A Lambert, Ryan M Schiedo, Thomas A Pieters, Michael P Stauff.

STUDY DESIGN: Narrative review.
OBJECTIVE: To summarize the epidemiology and oncologic patterns of metastatic and primary cervical spine tumors and evaluate the classification systems, instability assessments, cord compression frameworks, and prognostic tools used in their management.
SUMMARY OF BACKGROUND DATA: Although relatively uncommon, cervical spine tumors carry disproportionate clinical consequences. Epidural spinal cord compression can cause quadriplegia and respiratory failure, while the region's distinctive anatomy and biomechanics complicate oncologic decision-making.
METHODS: A narrative review of the literature was performed, focusing on the epidemiology, primary tumor origins, biologic behavior, classification, spinal instability, epidural spinal cord compression, and survival prediction relevant to metastatic and primary cervical spine tumors.
RESULTS: Metastatic neoplasms constitute most cervical spine tumors and most commonly arise from lung, breast, and prostate cancers. Primary cervical spine tumors account for ∼5-10% of spinal neoplasms and encompass diverse pathologies with distinct biologic behavior and management implications. Existing classification systems, instability assessments, cord compression frameworks, and prognostic scores support multidisciplinary decision-making but incompletely reflect cervical anatomic and biomechanical complexity. Furthermore, survival prediction models may underestimate prognosis in the era of modern systemic therapy and spinal stereotactic radiosurgery.
CONCLUSIONS: Cervical spine tumors require individualized, multidisciplinary evaluation that integrates tumor biology, neurologic status, mechanical stability, anatomic level, systemic disease burden, and anticipated survival. Current frameworks remain clinically useful adjuncts but should not replace comprehensive clinical judgment, particularly as oncologic and radiation treatments continue to improve.

Keywords: cervical spine tumors; metastatic epidural spinal cord compression; prognostic scoring systems; spinal instability; spinal metastases

DOI: https://doi.org/10.1097/BSD.0000000000002183

Neurochirurgie. 2026 Oct 08. pii: S0028-3770(26)00119-0. [Epub ahead of print] 101885

Anatomy and physiology of spinal metastasis.

Olivier Hamel.

Spinal metastases are common in the course of a neoplasm and involve multiple pathophysiological mechanisms. The venous vascularization of the spine plays an important role in the onset and development of these secondary lesions. Their progression leads to evolving risks of fracture and neurotoxicity, all of which compromise quality of life and survival. Understanding these harmful developments requires a knowledge of the bony and ligamentar structures and of the vertebral contents, including particularities of its venous drainage.

Keywords: Anatomy; Metastasis; Spinal cord; Spinal veins; Spine

DOI: https://doi.org/10.1016/j.neuchi.2026.101885

Zhonghua Nei Ke Za Zhi. 2026 Oct 01. 65(10): 1059-1066

[Expert consensus on composite co-ablation for pain caused by bone metastases].

Expert Committee on Radiological Interventional Therapy, Chinese Society of Clinical Oncology (CSCO)

Pain caused by bone metastases from malignant tumors is mediated by multiple mechanisms, including direct tumor invasion or nerve compression, release of inflammatory mediators, and peripheral/central sensitization, which severely compromise patients' quality of life and functional status. Composite co-ablation, through alternating cycles of deep cryogenic temperature (-196 ℃) and hyperthermia (80 ℃), offers advantages such as a large ablation volume per probe, lower tissue temperature than conventional cryoablation, a visible ice ball on imaging, and synergistic cryo-thermal effects. This technique achieves rapid pain relief while maximizing preservation of surrounding critical structures. To standardize the clinical application of composite co-ablation for pain caused by bone metastases from malignant tumors, the Radiation Interventional Oncology Committee of the Chinese Society of Clinical Oncology (CSCO), the Tumor Ablation Therapy Committee of CSCO, the Tumor Ablation Therapy Committee of the Chinese Anti-Cancer Association, and the Tumor Ablation Expert Working Group of the Chinese College of Interventionalists jointly organized nationwide experts to formulate this "Expert Consensus on Composite Co-ablation for Pain Caused by Bone Metastases", aiming to better guide clinical practice.

DOI: https://doi.org/10.3760/cma.j.cn112138-20260604-00342

Cancer Rep (Hoboken). 2026 Oct;9(10): e70689

Race and Socioeconomic Status are Predictors of Survival in Patients With Metastatic Bone Disease Secondary to Breast Cancer.

Ashley Castan, Rosamaria Dias, Amog Mysore, David Herz, Katie Gotoff, Yazan Kadkoy, Kathleen Beebe, Joseph Benevenia, Joseph Ippolito.

BACKGROUND: With implementation of early detection screening methods and advances in medical treatment, there have been improvement in outcomes for patients with breast cancer. Despite this, studies have suggested potential differences in outcomes amongst various racial and ethnic groups. To our knowledge, no study has evaluated if race and demographic characteristics impact survival outcomes in patients with breast cancer metastases to the bone.
AIMS: We sought to answer the following questions: (1) Does race, demographic, and tumor characteristics alter survival outcomes in patients with breast metastases to the bone? (2) When stratifying by income and treatment, does race influence survival outcomes in patients with breast metastases to the bone?
METHODS AND RESULTS: The surveillance, epidemiology, and end results (SEER) 2016 to 2021 database was reviewed for patients with a diagnosis of breast cancer with metastases to the bone N = 11 833. Patients with known primary breast cancer, known hormone receptor status, known metastasis to bone, known treatment regiment, and no additional cancer diagnoses were included. Using variables within the database, this study collected information on demographics and tumor characteristics. Multivariate analyses were conducted to determine associations between race and other demographic, clinical, and prognostic factors. Kaplan-Meier survival curves were utilized to evaluate outcome by race. Annual household income below $75 000 (hazard ratio 1.111 [95% confidence interval (CI): 1.047-1.178, p < 0.001]), age over 65 years old (hazard ratio 1.1150 [95% CI: 1.084-1.220, p < 0.001]), and race (black) (hazard ratio 1.256 [95% CI: 1.161-1.359, p < 0.001]) were independent risk factors for decreased survival likelihood. Surgery (hazard ratio 0.554 [95% CI: 0.507-0.606, p < 0.001]), chemotherapy (hazard ratio 0.421 [95% CI: 0.397-0.446, p < 0.001]), and radiation (hazard ratio 0.940 [95% CI: 0.885-0.998, p < 0.05]), were independent factors that increased survival. At 12-month follow-up (hazard ratio 1.211 [95% CI: 1.091-1.345, p < 0.001]) and 5-year follow-up (hazard ratio 1.256 [95% CI: 1.161-1.359, p < 0.001]) black women had decreased survival likelihood compared to all other races. When patients were stratified by annual household income greater than $75 000, regardless of treatment, black women had decreased survival likelihood in patients younger then 65 years old (hazard ratio 1.242 [95% CI: 1.117-1.381, p < 0.001]) and 65 years and older (hazard ratio 1.318 [95% CI: 1.121-1.550, p = 0.001]). Increasing age, race, and lower annual household income were significantly associated with higher mortality. When controlling for higher income and treatment variables, black women had significantly higher mortality rates at 5-year follow up.
CONCLUSION: Despite improved treatment methods, disparities among patients with metastatic breast cancer to bone exists. Our findings demonstrate that different sub-groups experience different mortality rates. Further research must be conducted to understand the interplay between these socioeconomic variables and survival likelihood in metastatic breast cancer.

Keywords: breast cancer; income; metastatic bone disease; race; survival

DOI: https://doi.org/10.1002/cnr2.70689

Eur J Surg Oncol. 2026 Oct 05. pii: S0748-7983(26)00814-0. [Epub ahead of print]52(12): 112195

Impact of pathological fracture on outcomes after surgery for metastatic femoral bone tumors: A multi-institutional study by the Tokai Musculoskeletal Tumor Consortium.

Tomohisa Sakai, Kunihiro Ikuta, Tetsuo Shimoyama, Tomohito Hagi, Hisaki Aiba, Akihito Nagano, Takaaki Tanaka, Junji Wasa, Yoji Shido, Kozo Hosono, Eiji Kozawa, Katsuhisa Kawanami, Shiro Imagama, Yoshihiro Nishida.

INTRODUCTION: The prognostic impact of pathological fractures in patients undergoing surgery for metastatic femoral bone tumors remains controversial.
MATERIALS AND METHODS: We retrospectively analyzed 176 patients (187 femurs) who underwent surgical management for metastatic femoral bone tumors at institutions affiliated with the Tokai Musculoskeletal Tumor Consortium. Overall survival (OS) was evaluated on a per-patient basis, whereas pathological fracture status and surgical procedures were assessed on a per-femur basis. Postoperative ambulatory function was examined as a measure of functional outcome. Multivariate Cox proportional hazards regression analysis identified independent prognostic factors. Subgroup analyses were performed in poor-prognosis cohorts, including patients treated with internal fixation and those with a modified Katagiri score ≥ 7.
RESULTS: The OS rates at 1 and 2 years postoperatively were 71.0% and 58.1%, respectively. Multivariate analysis identified age ≥ 65 years (p = 0.015), presence of visceral metastasis (p < 0.001), abnormal laboratory findings (p = 0.006), and postoperative decline in ambulatory function (p = 0.015) as independent predictors of poorer survival. Pathological fracture was not significantly associated with OS on univariate analysis (p = 0.66), including in subgroups of patients who underwent internal fixation and those with a modified Katagiri score ≥ 7. Although surgery after a pathological fracture showed a trend toward postoperative functional decline, this association did not reach statistical significance (p = 0.09).
CONCLUSIONS: Among patients with a relatively favorable prognosis undergoing surgery for metastatic femoral bone tumors, pathological fracture may indirectly affect outcomes through postoperative functional deterioration rather than directly affecting survival.

DOI: https://doi.org/10.1016/j.ejso.2026.112195