Gábor Czigléczki1, Tamás Mezei2, Péter Pollner3, Anna Horváth4, Péter Banczerowski5. 1. National Institute of Clinical Neurosciences, Semmelweis University, Budapest, Hungary; Department of Neurosurgery, Semmelweis University, Budapest, Hungary. Electronic address: gczigleczki@gmail.com. 2. Department of Neurosurgery, Semmelweis University, Budapest, Hungary. 3. MTA-ELTE Statistical and Biological Physics Research Group, Hungarian Academy of Sciences, Eötvös University, Statistical and Biological Physics Research Group, Budapest, Hungary. 4. 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary. 5. National Institute of Clinical Neurosciences, Semmelweis University, Budapest, Hungary; Department of Neurosurgery, Semmelweis University, Budapest, Hungary.
Abstract
OBJECTIVE: Oncologic treatments increase the incidence of spinal metastases. Surgical treatment of spinal metastases results in a high complication rate, which must set against the expected benefits. The aim of this article was to study the effect of several prognostic factors on surgical complications and survival time using an extended database of patients with spinal metastases. METHODS: This retrospective study comprised 337 patients with spinal metastases who were surgically treated between 2008 and 2015. Demographic and clinical features, oncologic histories, surgical interventions, and end results were collected. Descriptive statistical methods were used to analyze the cohort of patients. Kaplan-Meier formula and log-rank test were used to examine overall survival times. RESULTS: Median overall survival time was 222 days (range, 175-274 days). Age, preoperative motor disorders, preoperative Frankel grade categories, Karnofsky performance scale, type of primary tumor, and presence of internal metastasis had a significant negative effect on overall survival. Complications such as bleeding or need for intensive care could be predicted preoperatively based on preoperative performance status, type of primary tumor, affected vertebral levels, and type of surgical interventions. CONCLUSIONS: Spinal metastatic disease is a challenging surgical problem. If the exact prognostic factors are known preoperatively, surgical outcome and overall survival can be predicted more precisely. Our results could provide a basis for a future multicenter prospective study to determine the best treatment protocol for patients with spinal metastases.
OBJECTIVE: Oncologic treatments increase the incidence of spinal metastases. Surgical treatment of spinal metastases results in a high complication rate, which must set against the expected benefits. The aim of this article was to study the effect of several prognostic factors on surgical complications and survival time using an extended database of patients with spinal metastases. METHODS: This retrospective study comprised 337 patients with spinal metastases who were surgically treated between 2008 and 2015. Demographic and clinical features, oncologic histories, surgical interventions, and end results were collected. Descriptive statistical methods were used to analyze the cohort of patients. Kaplan-Meier formula and log-rank test were used to examine overall survival times. RESULTS: Median overall survival time was 222 days (range, 175-274 days). Age, preoperative motor disorders, preoperative Frankel grade categories, Karnofsky performance scale, type of primary tumor, and presence of internal metastasis had a significant negative effect on overall survival. Complications such as bleeding or need for intensive care could be predicted preoperatively based on preoperative performance status, type of primary tumor, affected vertebral levels, and type of surgical interventions. CONCLUSIONS: Spinal metastatic disease is a challenging surgical problem. If the exact prognostic factors are known preoperatively, surgical outcome and overall survival can be predicted more precisely. Our results could provide a basis for a future multicenter prospective study to determine the best treatment protocol for patients with spinal metastases.
Authors: Tamás Mezei; Anna Horváth; Péter Pollner; Gábor Czigléczki; Péter Banczerowski Journal: Int J Clin Oncol Date: 2020-01-28 Impact factor: 3.402