Literature DB >> 17108840

Impact of surgical intervention on quality of life in patients with spinal metastases.

Alexis Falicov1, Charles G Fisher, Joe Sparkes, Michael C Boyd, Peter C Wing, Marcel F Dvorak.   

Abstract

STUDY
DESIGN: Prospective clinical study.
OBJECTIVE: To assess Health-Related Quality of Life outcomes in patients undergoing surgery for spinal metastases. SUMMARY OF BACKGROUND DATA: Increasing life expectancy of patients with spinal metastases has resulted in greater interest in overall quality of life, including pain and neurologic impairment. To assess the overall risks and benefits of surgical intervention, the overall impact of each on the overall health status must be assessed.
METHODS: All patients who presented to a single institution with bony spinal metastases requiring surgical intervention were eligible. EXCLUSION CRITERIA: previous surgery for spinal metastases, primary tumors of the spine, and inability to fill out the questionnaires. Patients completed an EORTC QLQ-C30, the HUI-3, the EQ-5D, visual analog pain, and an ECOG functional assessment. at five points: before surgery and at 6 weeks, 3 months, 6 months, and 1 year post surgery.
RESULTS: Of 96 patients who presented to the hospital, 85 were enrolled in the study. Average age was 58.6 years (range, 20.3-80.7 years) with 47 male patients; 50% survival as 39.1 weeks. Maximal and average VAS pain levels showed a statistically significant (P < 0.00001) improvement from preoperative to all postoperative time points. Only the QLQ-C30 global health status showed a statistically significant improvement from preoperative to the 6-week (P = 0.017), 3-month (P = 0.039), and 6-month (P = 0.013) time points. There was a statistically significant correlation between baseline global health status and survival time (P = 0.041). Overall distribution of HUI-3 utility calculated Quality of Life Adjusted Years (QALY) during the 1-year postoperative period showed a bimodal distribution with peaks at 0.1 and 0.7 years.
CONCLUSIONS: Surgery for patients with spinal metastases offers decreased pain and improved quality of life with low rates of surgical complications.

Entities:  

Mesh:

Year:  2006        PMID: 17108840     DOI: 10.1097/01.brs.0000245838.37817.40

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  50 in total

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Review 3.  Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group.

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4.  Reducing kyphotic deformity by posterior vertebral column resection with 360° osteosynthesis in metastatic epidural spinal cord compression (MESCC).

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5.  Predictors of quality of life improvement after surgery for metastatic tumors of the spine: prospective cohort study.

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6.  Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases.

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7.  Surgery improves pain, function and quality of life in patients with spinal metastases: a prospective study on 118 patients.

Authors:  Gerald M Y Quan; Jean-Marc Vital; Nicholas Aurouer; Ibrahim Obeid; Jean Palussière; Abou Diallo; Vincent Pointillart
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8.  Health-related Quality of Life in Patients with Metastatic Spinal Cord Compression.

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9.  The outcome and survival of palliative surgery in thoraco-lumbar spinal metastases: contemporary retrospective cohort study.

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10.  Predictive value of seven preoperative prognostic scoring systems for spinal metastases.

Authors:  Andreas Leithner; Roman Radl; Gerald Gruber; Markus Hochegger; Katharina Leithner; Heike Welkerling; Peter Rehak; Reinhard Windhager
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