Spinal metastases from myxoid liposarcoma warrant screening with magnetic resonance imaging Journal Article


Authors: Schwab, J. H.; Boland, P. J.; Antonescu, C.; Bilsky, M. H.; Healey, J. H.
Article Title: Spinal metastases from myxoid liposarcoma warrant screening with magnetic resonance imaging
Abstract: BACKGROUND. Myxoid liposarcoma (MLS) has an unusual tendency for extrapulmonary metastasis, particularly to the spine and soft tissues. The objective of this study was to determine the prevalence of spinal metastasis, treatment outcomes, and optimal screening method for spinal metastasis in patients with MLS. METHODS. Data from patients with had spinal metastases were obtained from the authors' institutional soft tissue sarcoma database. The accuracy with which positron emission tomography (PET) scans and bone scans identified metastatic lesions was compared with the accuracy of magnetic resonance imaging (MRI). Clinical response to treatment was based on pain, neurologic scores, and survivorship analysis. RESULTS. There were 33 patients who developed spinal metastasis after a median 36 months of follow-up (range, from 7.5 months to 33 years). Known spinal metastases were detected by bone scans in 16% of patients and by PET scans in 14% of patients. Patients who underwent surgery had high-grade spinal cord compression more often than patients who did not undergo surgery (72% vs 19%, respectively; P = .002). Pain and neurologic function were improved or maintained in all patients who received radiation alone (n = 8 patients) and in all but 1 patient who underwent surgery (n = 18 patients). The median overall survival was 51.4 months from the time of primary diagnosis and 21.9 months from the time of first metastasis. CONCLUSIONS. Bone scans and PET scan lack sufficient sensitivity to detect spinal metastasis from MLS. Treatment of metastasis is palliative, but local treatment can yield long-term disease control in select patients. Screening with whole-spine MRI may lead to the earlier detection of spinal metastasis. © 2007 American Cancer Society.
Keywords: adult; cancer survival; clinical article; aged; middle aged; cancer surgery; survival rate; overall survival; nuclear magnetic resonance imaging; positron emission tomography; follow up; magnetic resonance imaging; diagnostic accuracy; sensitivity and specificity; radiopharmaceuticals; pain; image analysis; cancer screening; diagnostic imaging; data base; survival time; spinal cord compression; spinal neoplasms; fluorodeoxyglucose f18; positron-emission tomography; predictive value of tests; cancer control; neurologic disease; soft tissue neoplasms; bone scintiscanning; spine metastasis; myxosarcoma; myxoid liposarcoma; spinal metastasis; bone scan; liposarcoma, myxoid; positron emission tomography scan
Journal Title: Cancer
Volume: 110
Issue: 8
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2007-10-15
Start Page: 1815
End Page: 1822
Language: English
DOI: 10.1002/cncr.22992
PUBMED: 17724681
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus"
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MSK Authors
  1. Joseph H Schwab
    13 Schwab
  2. Patrick J Boland
    160 Boland
  3. Mark H Bilsky
    319 Bilsky
  4. Cristina R Antonescu
    895 Antonescu
  5. John H Healey
    547 Healey