Clinical features and management experience in patients with metastatic spinal bladder cancer: a single-institution 10-year retrospective study

Background: Limited case reports of metastatic spinal bladder cancer (MSBC) have been published to date. Owing to the rarity of this condition, it has not been well-studied and it is thus difficult to predict patient prognosis or to plan appropriate clinical treatment strategies for MSBC. This study is by far the largest clinical case series on MSBC worldwide. Methods: Six patients with MSBC were included from January 2010 to May 2020 at the bone tumor center of orthopedics department in Peking Union Medical College Hospital. Clinical information, radiological data, operative notes, and pathological results of all patients were reviewed. Baseline clinical data of all patients were retrospectively analyzed, and regular follow-up was performed postoperatively. Overall survival (OS) was the time from the initial spinal surgery to the death of patients or the end of May 2020, whichever came first. Results: All six patients with MSBC were male patients, with an average age of 68.1 +/- 12.8 years. The mean interval between surgery for primary BC and the first discovery of spinal metastases was 15.6 [2-33] months. Overall, nine spinal operations were performed in the six patients. The mean follow-up period was 11.0 +/- 4.2 (range, 7-18) months. All patients (100%) died from MSBC during the follow-up period, with a mean OS of 11.0 +/- 4.2 (range, 7-18) months. Conclusions: Patients with MSBC had a poor prognosis in this study. Spinal surgery combined with adjuvant therapy may contribute to relieving the clinical symptoms and improve the quality of life of patients. Appropriate surgical treatment options should be selected according to patients' general condition and relevant characteristics of spinal metastases.