BACKGROUND: Surgery for spinal metastasis is a palliative treatment aimed at improving patient quality of life by alleviating pain and reversing or delaying neurologic dysfunction, but with a mean survival time of less than 1 year and significant complication rates, appropriate patient selection is crucial. OBJECTIVE: To identify the most significant prognostic variables of survival after surgery for spinal metastasis. METHODS: Chart review was performed on 200 surgically treated spinal metastasis patients at Stanford Hospital between 1999 and 2009. Survival analysis was performed and variables entered into a Cox proportional hazards model to determine their significance. RESULTS: Median overall survival was 8.0 months, with a 30-day mortality rate of 3.0% and a 30-day complication rate of 34.0%. A Cox proportional hazards model showed radiosensitivity of the tumor (hazard ratio: 2.557, P<.001), preoperative ambulatory status (hazard ratio: 2.355, P=.0001), and Charlson Comorbidity Index (hazard ratio: 2.955, P<.01) to be significant predictors of survival. Breast cancer had the best prognosis (median survival, 27.1 months), whereas gastrointestinal tumors had the worst (median survival, 2.66 months). CONCLUSION: We identified the Charlson Comorbidity Index score as one of the strongest predictors of survival after surgery for spinal metastasis. We confirmed previous findings that radiosensitivity of the tumor and ambulatory status are significant predictors of survival.
BACKGROUND: Surgery for spinal metastasis is a palliative treatment aimed at improving patient quality of life by alleviating pain and reversing or delaying neurologic dysfunction, but with a mean survival time of less than 1 year and significant complication rates, appropriate patient selection is crucial. OBJECTIVE: To identify the most significant prognostic variables of survival after surgery for spinal metastasis. METHODS: Chart review was performed on 200 surgically treated spinal metastasis patients at Stanford Hospital between 1999 and 2009. Survival analysis was performed and variables entered into a Cox proportional hazards model to determine their significance. RESULTS: Median overall survival was 8.0 months, with a 30-day mortality rate of 3.0% and a 30-day complication rate of 34.0%. A Cox proportional hazards model showed radiosensitivity of the tumor (hazard ratio: 2.557, P<.001), preoperative ambulatory status (hazard ratio: 2.355, P=.0001), and Charlson Comorbidity Index (hazard ratio: 2.955, P<.01) to be significant predictors of survival. Breast cancer had the best prognosis (median survival, 27.1 months), whereas gastrointestinal tumors had the worst (median survival, 2.66 months). CONCLUSION: We identified the Charlson Comorbidity Index score as one of the strongest predictors of survival after surgery for spinal metastasis. We confirmed previous findings that radiosensitivity of the tumor and ambulatory status are significant predictors of survival.
Authors: Ameen Al-Omair; Laura Masucci; Laurence Masson-Cote; Mikki Campbell; Eshetu G Atenafu; Amy Parent; Daniel Letourneau; Eugene Yu; Raja Rampersaud; Eric Massicotte; Stephen Lewis; Albert Yee; Isabelle Thibault; Michael G Fehlings; Arjun Sahgal Journal: Neuro Oncol Date: 2013-10 Impact factor: 12.300
Authors: C Bouthors; S Prost; C Court; B Blondel; Y P Charles; S Fuentes; H P Mousselard; C Mazel; C H Flouzat-Lachaniette; P Bonnevialle; F Saihlan Journal: Support Care Cancer Date: 2019-08-09 Impact factor: 3.603
Authors: Zain A Husain; Isabelle Thibault; Daniel Letourneau; Lijun Ma; Harald Keller; John Suh; Veronica Chiang; Eric L Chang; Raja K Rampersaud; James Perry; David A Larson; Arjun Sahgal Journal: CNS Oncol Date: 2013-05