Evidence map›Paper›PMID 34742319›Full record

SynthesisJournal of orthopaedic surgery and research2021

What is the effectiveness of radiofrequency ablation in the management of patients with spinal metastases? A systematic review and meta-analysis.

Navanith Murali, Thomas Turmezei, Sumbal Bhatti, Puja Patel, Thomas Marshall, Toby Smith

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06120426 (En Bloc Resection Versus Separation Surgery Combined With Radiotherapy for the Treatment of Spinal Oligometastatic Tumor-A Multi-center, Prospective, Randomized, Controlled Study.), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06120426 recruitingnot on this mapstarted 2023, after this paper: background citation

En Bloc Resection Versus Separation Surgery Combined With Radiotherapy for the Treatment of Spinal Oligometastatic Tumor-A Multi-center, Prospective, Randomized, Controlled Study.

Typeobservational_patient_registrySponsorShanghai Changzheng HospitalRan2023 to 2027Enrolled182ConditionsSpinal Metastases, Spinal Tumor, Radiotherapy, Malignant Bone TumorArmstotal en bloc spondylectomy
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Development and validation of a radiofrequency ablation treatment planning system for vertebral metastases.International journal of computer assisted radiology and surgery · 2023
    Article
  8. Review
  9. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Navanith MuraliNorwich Medical School, University of East Anglia, Norwich, UK. N.Murali@uea.ac.uk.ORCID http://orcid.org/0000-0001-6695-7380
Thomas TurmezeiNorwich Medical School, University of East Anglia, Norwich, UK.
Sumbal BhattiNorwich Medical School, University of East Anglia, Norwich, UK.
Puja PatelNorwich Medical School, University of East Anglia, Norwich, UK.
Thomas MarshallDepartment of Radiology, Norfolk & Norwich University Hospital, Norwich, UK.
Toby SmithNorwich Medical School, University of East Anglia, Norwich, UK.
University of East Anglia · GBNorfolk and Norwich University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSpinal metastases are indicative of progressive cancer which can lead to vertebral body fractures and spinal cord compression. Radiofrequency ablation (RFA) treatment is infrequently used in patients with refractory pain. The aim of this systematic review is to determine the clinical efficacy of RFA, with the scope of using it as front-line management of spinal metastases.

methodsElectronic databases were searched (to July 2020) for studies evaluating RFA treatment for spinal metastases in adults. Measured outcomes were pain (primary), disability, health-related quality of life (HRQOL), complications, tumour control and mortality. Study inclusion, data extraction and risk of bias using the ROBIN-I tool were assessed. Meta-analysis was conducted for pooled results with homogeneity, and narrative synthesis was conducted otherwise.

results15 studies were included. RFA reduces pain scores at 3-5 weeks [standardised mean difference (SMD 2.24, 95% confidence intervals (CI) 1.55-2.93], 3-4 months (SMD 3.00, 95% CI 1.11-4.90) and 5-6 months (SMD 3.54, 95% CI 1.96-5.11). RFA is effective in reducing disability/improving HRQOL in the short-term but longer-term efficacy remains unclear. 13.2% cases reported local tumour control failure (2.5 months-5 year follow-up) whereas mortality was 23.6% (follow-up of up to 1 year).

conclusionLow quality evidence has proven RFA to be safe and effective in reducing pain and disability, especially in the short-term. RFA may be routinely implemented in all cases involving refractory pain or radiotherapy-resistant tumours but controlled trials are required to compare the efficacy of RFA to current frontline treatments. PROSPERO protocol registration number: CRD42020202377.

Indexed as

Catheter AblationIntractable PainRadiofrequency AblationSpinal FracturesSpinal NeoplasmsAdultHumansQuality of LifeBack painRadiofrequency ablationRadiotherapySpinal cord compressionSpinal metastases

Identifiers

PMID34742319
PMCPMC8571892
OpenAlexW3214092088

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.