Metastatic adenocarcinoma of the spine.
Eighty-six patients presenting with metastatic adenocarcinoma of the spine were retrospectively reviewed. Forty-nine patients had neurologic compromise: paraplegia developed in 23 patients and loss of anal or urethral sphincter control occurred in 17 patients. Anterior decompression was performed in 35 patients and posterior decompression in 14 patients. The rest of the patients were treated nonoperatively. Neurologic recovery in the operated cases was unsatisfactory. We found that this particular histologic type of spinal metastasis is highly invasive and aggressive. Survival analysis in 74 evaluable patients showed a median survival time of 76 days, which was not affected by the presence of multiple lesions or neurologic compromise. Surgical decompression had no positive impact on survival of the patients. Therefore, it is suggested that nonoperative treatment should be the guideline, and operative treatment should be offered only to carefully selected cases of metastatic adenocarcinoma of the spine.