Prevalence and patterns of metastatic tumors to the spine among adult patients at Mulago National Referral Hospital and Uganda Cancer Institute

Abstract

Introduction: Metastatic tumors to the spine pose significant clinical challenges and represent a common complication in advanced cancer patients. At least 30% to 70% of cancer patients may experience metastasis to the spine. This study sought to establish the prevalence and patterns of presentation of metastatic tumors to the spine among adult patients with spine tumors attending Mulago National Referral Hospital and Uganda Cancer Institute. Methods: This was a cross-sectional study. 184 participants were recruited consecutively from the wards and clinics of UCI and MNRH between January and March 2024. Data was collected on participants’ demographics, clinical presentation and radiological patterns. Radiological patterns were assessed using Weinstein-Boriani-Biagini (WBB) classification. The prevalence of metastatic tumors to the spine was established using proportions with a 95% CI. Bivariate and multi variate analysis was used in analysis for relationship between participants’ presentations with the tumors they presented with. Relative Risk Ratios were used to measure association using Multinomial regression. Results: The mean ± SD age of the participants was 57.0 ± 15.4 years. Range was 19–83 years. Male: Female ratio was1.1:1(96:88). The prevalence of metastatic tumors to the spine was 87.5%, Prostate (41.6%) and Breast (41.0%) were the commonest primary tumor. 78.3% of participants presented with lower back pain, radicular in 59.5%. 27.0% had bladder sphincter loss. Thoracic region was most affected n=71 followed by lumber n=52. At multivariate, Participants with a lower limb sensation of two were six times more likely to present with Breast rather than Prostate cancer when compared to their counterparts who had a sensation of one. RRR=6.228(1.140,34.016) P= 0.035. and, participants where vertebral collapse was absent were more likely to have Prostate rather than other metastatic cancers as compared with their counterparts where it was present 0.076(0.017,0.331) p=0.001. Conclusion: The prevalence of metastatic spine tumors among adult patients at Mulago NRH and UCI was high at 87.5%, Prostate and breast cancer were the most prevalent primary cancers respectively.