Introduction: Spinal metastases from gynecological cancers are rare with few cases reported in the literature. In this study, we examine a series of patients with metastatic gynecological cancer to the spine and review the literature.

Methods: We retrospectively reviewed 6 consecutive patients who underwent spine surgery for metastatic gynecological cancer between 2007 and 2012 at a single institution. We recorded demographic, operative, and postoperative factors were reviewed and the functional outcomes were determined by change in Karnofsky Performance Status (KPS) and modified Rankin Scale (mRS) during follow-up. We also performed a systematic review of the literature to evaluate outcomes of patients with similar gynecological metastases to the spine.

Results: In our series, details regarding metastatic gynecological cancers to the spine are as follows: 2 patients with cervical cancer (both presented at age 46 years), 2 patients with endometrial cancer (mean age of 40 years), and 2 patients with leiomyosarcoma (mean age of 44 years). All patients presented with pain, and no complications were noted following surgery. All of our patients with known follow-up had stable or improved neurologic outcomes, performance status, and improved pain without local recurrence of tumor. Overall median survival after diagnosis of metastatic spine lesions for all literature cases as well as our cases was 15 months. When broken down by type, median survival of cervical cancer, endometrial cancer, and leiomyosarcoma patients was 32, 10, and 22.5 months, respectively.

Conclusions: Gynecological cancers metastasizing to the spine are rare. Combined with literature cases, survival differs depending on primary histology, with decreasing survival from cervical (32 months) to leiomyosarcoma (22.5 months) to endometrial (9 months). Integrating such information with other patient factors may more accurately guide decision making regarding management of such spinal lesions.

Patient Care: This research provides surgeons with information to effectively counsel patients and determine appropriate treatment paradigms based on life expectancy for patients diagnosed with a gynecologic cancer metastasis to the spine.

Learning Objectives: By the conclusion of this session, participants should be able to discuss the functional outcomes and survival of patients with metastatic gynecological cancer to the spine in the existing literature.

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