SURVIVAL RATES OF PATIENTS WITH METASTATIC SPINAL CANCER AFTER SCINTIGRAPHIC DETECTION OF ABNORMAL RADIOACTIVE ACCUMULATION

Study Design. This retrospective study analyzes the timing of spinal m etastases and the survivability of patients with cancer after the dete ction of spinal metastases. Objective. To evaluate the timing of spina l metastases in primary lesions and survivability of patients with met astatic spinal tumors. Summary of Background Data. Few studies have an alyzed the influence of primary lesions on survival rates of patients with metastatic spinal tumors. Methods. This is a review of bone scint igraphy that was performed serially in patients with pulmonary cancer, breast cancer, prostatic cancer, cervical cancer, renal cancer, and g astric cancer from 1980 to 1991. To exclude false-positive cases, the spinal areas showing abnormal accumulation on bone scintigrams were fu rther examined by other methods of diagnostic imaging. The timing of s cintigraphic detection of spinal metastases and the survivability were studied in 425 patients with spinal metastases. The survivability aft er spinal accumulation was determined by the Kaplan-Meier survival cur ve. Results. The mean period, from the diagnosis of the primary lesion to the detection of abnormal accumulation in the spine, was shortest in pulmonary cancer (3.6 +/- 6.1 months), and it was longest in breast cancer (29.4 +/- 33.5 months). The 1-year survival rate was high in b reast cancer (78%) and prostatic cancer (83%), and it was low in pulmo nary cancer (22%) and gastric cancer (0%), respectively. The 6-month s urvival rate of gastric cancer was 15%. Conclusions. When managing met astic spinal tumors, it is essential to select therapeutic methods bas ed on adequate consideration of the features of primary lesions and th e expected prognosis.