Separation Operation Followed by Stereotactic Radiotherapy in the Treatment of Spinal Metastasis From Hepatocellular Carcinoma: A Retrospective Cohort Study

Hepatocellular carcinoma (HCC) often spreads to the spine, causing compression of the spinal cord and nerve damage, leading to a poor quality of life. This study explores whether combining a separation operation (SO) with stereotactic radiotherapy (SRT/SRS) can improve outcomes for these patients compared to using SRT/SRS alone. The separation operation involves removing parts of the tumor, reconstructing spinal stability with bone cements and screws, and separating the tumor from the spinal cord. SRT/SRS is then used to target any remaining tumor cells. The study compares patients who received both treatments (SO group) with those who received only SRT/SRS (RT group). The study found that patients who underwent the separation operation followed by SRT/SRS experienced greater pain relief, improved neurological function, and a better quality of life compared to those who received SRT/SRS alone, suggesting that this combination therapy may be a beneficial approach.

• 1
  Patients in the SO group demonstrated significantly higher VAS pain scores after treatment compared to the RT group, indicating better pain management with the combined approach.
• 2
  The SO group showed improved Frankel grades at the 3-month follow-up compared to the RT group, suggesting better neurological function recovery with the separation operation and SRS combination.
• 3
  Quality of Life (SF-36) scores were significantly better in the SO group compared to the RT group at the 3-month follow-up across multiple dimensions, indicating an overall improvement in the quality of life with the combined treatment.