Prophylactic Effect of Liaison Treatment on the Occurrence of Skeletal-Related Events in Patients with Metastatic Spinal Tumours: An Exploratory Interrupted Time Series Study

Spine Surg Relat Res. 2021 Jun 11;6(1):26-30. doi: 10.22603/ssrr.2021-0041. eCollection 2022.


Introduction: There is a growing momentum for the collaboration between multiple disciplines for the prevention and treatment of skeletal-related events (SREs) in patients with metastatic spinal tumors. However, the effectiveness of multidisciplinary approaches remains unclear. Hence, we conducted an exploratory study to examine the impact of liaison treatment for metastatic spinal tumor (LMST) on the prevention of SREs among patients with a metastatic spinal tumor.

Methods: This study was an exploratory interrupted time series conducted in a single medical center. Overall, 1,043 patients with a metastatic spinal tumor diagnosed between January 2011 and December 2020 were included. The LMST was implemented in January 2014. The LMST team consisted of the orthopedic surgery, thoracic surgery, breast and thyroid surgery, clinical oncology, urology, and radiology departments. Monthly joint conferences were held for patients with spinal instability, and the incidence of SRE was measured at 6-month intervals.

Results: Throughout the study period, we identified 66 SRE incidences. After the implementation of the LMST, a level change of -5.2% (95% confidence interval [CI]: -11.7 to 1.3, p = 0.11) was observed. Subsequently, a post-implementation trend change of -0.3% (95% CI: -2.0 to 1.5, p = 0.75) beyond the baseline was noted.

Conclusions: We suggest both immediate and gradual effects of the introduction of the LMST on deterring the development of SREs. Our results support the global trend of introducing a multidisciplinary approach for the treatment of metastatic spinal tumors.

Keywords: interrupted time series; liaison; metastatic spinal tumor; multidisciplinary approach; skeletal-related event.