C Mazel1, P Owona2, A Cogan2, L Balabaud2, D Grunenwald3. 1. Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France; Paris XIII, Sorbonne-Paris-Cité, 99, avenue Jean-Baptiste-Clément, 93430 Villetaneuse, France. Electronic address: cristian.mazel@imm.fr. 2. Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France. 3. Service de chirurgie thoracique, groupement hospitalier universitaire Est, AP-HP Tenon, 4, rue de la Chine, 75020 Paris, France.
Abstract
OBJECTIVE: Assess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France. INTRODUCTION: Life expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question. MATERIALS AND METHODS: Twenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3-25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France. RESULTS: The mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36. CONCLUSION: Appropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level. LEVEL OF EVIDENCE: Level IV; retrospective clinical study.
OBJECTIVE: Assess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France. INTRODUCTION: Life expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question. MATERIALS AND METHODS: Twenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3-25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France. RESULTS: The mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36. CONCLUSION: Appropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level. LEVEL OF EVIDENCE: Level IV; retrospective clinical study.
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Authors: Raphaële Charest-Morin; Charles G Fisher; Arjun Sahgal; Stefano Boriani; Ziya L Gokaslan; Aron Lazary; Jeremy Reynolds; Chetan Bettegowda; Laurence D Rhines; Nicolas Dea Journal: Global Spine J Date: 2019-05-08
Authors: Nuno Rui Paulino Pereira; Stein J Janssen; Nicky Stoop; Stefan Hartveldt; Yen-Lin E Chen; Thomas F DeLaney; Francis J Hornicek; Joseph H Schwab Journal: Global Spine J Date: 2019-02-18
Authors: Alex Oliveira de Araujo; Douglas Kenji Narazaki; William Gemio Jacobsen Teixeira; Cesar Salge Ghilardi; Pedro Henrique Xavier Nabuco de Araujo; Antônio Eduardo Zerati; Raphael Martus Marcon; Alexandre Fogaça Cristante; Tarcísio Eloy Pessoa de Barros Filho Journal: Clinics (Sao Paulo) Date: 2018-05-03 Impact factor: 2.365