{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:59Z","timestamp":1760144519235,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Spine Foundation (DWS)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Malignant spinal lesions (MSLs) are frequently the first manifestation of malignant disease. Spinal care, diagnostic evaluation, and the initiation of systemic therapy are crucial for outcomes in patients (pts) with advanced cancer. However, histopathology (HP) may be time consuming. The additional evaluation of spinal lesions using cytopathology (CP) has the potential to reduce the time to diagnosis (TTD) and time to therapy (TTT). CP and HP specimens from spinal lesions were evaluated in parallel in 61 pts (CP\/HP group). Furthermore, 139 pts in whom only HP was performed were analyzed (HP group). We analyzed the TTD of CP and HP within the CP\/HP group. Furthermore, we compared the TTD and TTT between the groups. The mean TTD in CP was 1.7 \u00b1 1.7 days (d) and 8.4 \u00b1 3.6 d in HP (p &lt; 0.001). In 13 pts in the CP\/HP group (24.1%), specific therapy was initiated based on the CP findings in combination with imaging and biomarker results before completion of HP. The mean TTT in the CP\/HP group was 21.0 \u00b1 15.8 d and was significantly shorter compared to the HP group (28.6 \u00b1 23.3 d) (p = 0.034). Concurrent CP for MSLs significantly reduces the TTD and TTT. As a result, incorporating concurrent CP for analyzing spinal lesions suspected of malignancy might have the potential to enhance pts\u2019 quality of life and prognosis in advanced cancer. Therefore, we recommend implementing CP as a standard procedure for the evaluation of MSLs.<\/jats:p>","DOI":"10.3390\/cancers16091659","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T08:08:32Z","timestamp":1714032512000},"page":"1659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Combined Cyto- and Histopathological Diagnostic Approach Reduces Time to Diagnosis and Time to Therapy in First Manifestation of Metastatic Spinal Disease: A Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Leon-Gordian","family":"Leonhardt","sequence":"first","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8341-9525","authenticated-orcid":false,"given":"Annika","family":"Heuer","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1232-2878","authenticated-orcid":false,"given":"Martin","family":"Stangenberg","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"},{"name":"Department of Spine and Neurosurgery, Hospital Tabea Hamburg, 22587 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-9309","authenticated-orcid":false,"given":"Lutz","family":"Welker","sequence":"additional","affiliation":[{"name":"Institute of Pathology with the Sections Molecular Pathology and Cytopathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunhild","family":"von Amsberg","sequence":"additional","affiliation":[{"name":"IInd Medical Clinic and Policlinic for Oncology, Hematology, Bone Marrow Transplantation with Department of Pneumology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-9582","authenticated-orcid":false,"given":"Andr\u00e9","family":"Strahl","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1055-8695","authenticated-orcid":false,"given":"Marc","family":"Dreimann","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"},{"name":"Center for Spine Surgery, Clinic for Neuroorthopedics and Spinal Cord Injuries, Orthopedic Clinic Markgr\u00f6ningen gGmbH, 71706 Markgr\u00f6ningen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-7810","authenticated-orcid":false,"given":"Carsten","family":"Bokemeyer","sequence":"additional","affiliation":[{"name":"IInd Medical Clinic and Policlinic for Oncology, Hematology, Bone Marrow Transplantation with Department of Pneumology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart","family":"Viezens","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Marie","family":"Asemissen","sequence":"additional","affiliation":[{"name":"IInd Medical Clinic and Policlinic for Oncology, Hematology, Bone Marrow Transplantation with Department of Pneumology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6243s","DOI":"10.1158\/1078-0432.CCR-06-0931","article-title":"Clinical features of metastatic bone disease and risk of skeletal morbidity","volume":"12","author":"Coleman","year":"2006","journal-title":"Clin. 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