Basic Science Research
My lab investigates genetic predictors and cellular mechanisms of metastatic progression to the bone and spine, as well as the functional consequences of disease recurrence and progression. Currently, we are focused on the role of UDP-Glucose 6-dehydrogenase (UGDH) in the progression of hormone-dependent cancers (breast and prostate). UGDH produces UDP-glucuronic acid, a component of glycosaminoglycans (GAGs) and proteoglycans (PGs) of the extracellular matrix, which are implicated in a variety of human diseases, including the progression of tumors. In one of our previous studies, we identified UGDH as an important regulator of migration, cell proliferation and tumor formation. We are currently investigating the role of UGDH in brain and bone metastases. In the coming year, we will develop animal models of spine metastases and epidural spinal cord compression, and investigate molecular alterations and genetic signatures associated with spine tumor phenotypes (i.e. bone only vs. epidural disease). Our goal is to identify novel molecular predictors and therapeutic targets that will aid in the optimization of treatment paradigms for spine tumor patients
Animal models of spine tumors
- Sarabia-Estrada R, Ruiz-Valls A, Guerrero-Cazares H, et al. Metastatic human breast cancer to the spine produces mechanical hyperalgesia and gait deficits in rodents. Spine J. 2017;17(9):1325-1334
- Sarabia-Estrada R, Ruiz-Valls A, Shah SR, et al. Effects of primary and recurrent sacral chordoma on the motor and nociceptive function of hindlimbs in rats: an orthotopic spine model. Journal of neurosurgery. 2017;27(2):215-226.
Genetic signatures associated with spine tumor phenotypes
In parallel, we are investigating predictors of Health-Related Quality of Life (HRQOL) and clinical outcomes in patients diagnosed with spinal tumors. Primarily, we aim to identify patient-specific, treatment-specific, and/or system-specific factors (sociodemographic, neurologic status, radiographic spinopelvic parameters, peri-operative, genetic signatures, etc.) that are associated with HRQOL and clinical outcomes in spine tumor patients. We also evaluate the impact of resource/technology timing and utilization on patient-specific expectations and outcomes (i.e. palliative care, robot-assisted surgery, etc.). The goal of these studies is to identify optimal therapeutic interventions and prognostic factors for patients diagnosed with metastatic or primary spine tumors and to improve clinical outcomes. Currently I am PI for two clinical studies (MTRON, DSOS) enrolling patients, and I am sub-PI on two other studies focusing on spine tumors.
Major areas of focus
Health-Related Quality of Life in Spine Tumors
- Barzilai O, Versteeg AL, Goodwin CR, et al. Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression.Cancer. 2019;125(23):4224-4231.
- Sankey EW, Park C, Howell EP, et al. Importance of Spinal Alignment in Primary and Metastatic Spine Tumors. World Neurosurg. 2019;132:118-128
- Goodwin CR, Ahmed AK, Boone C, et al. The Challenges of Renal Cell Carcinoma Metastatic to the Spine: A Systematic Review of Survival and Treatment. Global Spine J. 2018;8(5):517-526
- Howell EP, Williamson T, Karikari I, et al. Total en bloc resection of primary and metastatic spine tumors. Ann Transl Med. 2019;7(10):226.
Socioeconomic Disadvantage and Healthcare Disparity
- Elsamadicy AA, Kemeny H, Adogwa O, et al. Influence of racial disparities on patient-reported satisfaction and short- and long-term perception of health status after elective lumbar spine surgery. Journal of neurosurgery. 2018;29(1):40-45
- Abdelgadir J, Ong EW, Abdalla SM, et al. Demographic Factors Associated with Patient-Reported Outcome Measures in Pain Management. Pain Physician. 2020;23(1):17-24
Peri-operative Optimization and Risk Stratification
- Pennington Z, Pielkenrood B, Ahmed AK, Goodwin CR, Verlaan JJ, Sciubba DM. Visceral Fat Volume From Standard Preoperative CT is an Independent Predictor of Short-term Survival in Patients Undergoing Surgery for Metastatic Spine Disease. Clin Spine Surg. 2019;32(6):E303-E310.
- Ehresman J, Ahmed AK, Schilling A, et al. Preoperative Nutrition Consults Associated with Decreased Postoperative Complication Rate and Decreased Length of Hospital Stay After Spine Metastasis
Surgery. World Neurosurg. 2020;133:e173-e179