Surgical treatment tactics for patients with metastases of renal cancer in the spine

Vertebroplasty, stabilization, vertebrectomy Kidney cancer accounts for about 3% of all cancers in adults and about 90% of all malignant neoplasms of the kidney. Kidney cancer has a high metastatic potential. Thus, metastases in the spine are detected during diagnostics in 25-30% patients, and additional 25-50% cases are detected during treatment or at various times after the surgical treatment of the primary tumor. Mostly, kidney cancer bone metastases are multiple, however solitary spinal lesion occurs with a frequency of up to 30%. Non-surgical therapy for pathological vertebral fractures and neurological deficits is ineffective. At present, surgical treatment for metastatic spine lesions is divided into 2 types: radical and palliative. Radical surgical treatment of solitary metastases of kidney cancer in the spine significantly increases overall survival. Palliative surgical treatment of metastatic spine injury can improve the quality of life in more than 80% of patients. However, the choice of surgical treatment tactics for patients with metastases in the spine remains an urgent issue, which requires additional research. Another urgent matter would be to create a universal algorithm of patient examination and extent of surgical operation estimation. At the time oncologists use various oncoorthopedic scales to determine the prognosis and extent of operation, unfortunately, they do not take into account the development of metastatic kidney cancer and the possibilities of modern systemic treatment. In recent decades, numerous studies have been conducted on the research of possible factors that may predict the survival of patients with disseminated kidney cancer and created predictive models R.J. Motzer, D. Heng. However, these scales do not take into account the orthopedic aspects and there are no recommendations for performing a surgical treatment of metastatic spine injury, therefore, without appropriate adaptation, they cannot be used in oncortopedics. Treatment of patients with metastases of kidney cancer in the spine is a complex and urgent problem that still does not have unified standards and requires additional research.

kidney cancer, metastases in the spinal column, pathological fractures, compression syndrome, oncological prognosis, prognostic models, surgical treatment, vertebroplasty, stabilization, vertebrectomy

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