Fabio Cofano1, Giuseppe Di Perna2, Francesco Zenga2, Alessandro Ducati2, Bianca Baldassarre2, Marco Ajello2, Nicola Marengo2, Luca Ceroni3, Michele Lanotte4, Diego Garbossa2. 1. Department of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy. Electronic address: fabio.cofano@gmail.com. 2. Department of Neuroscience "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy. 3. Psychological Sciences and Techniques, Psychology Department, University of Turin, Italy. 4. Department of Neuroscience "Rita Levi Montalcini", Stereotactic and Functional Neurosurgical Unit, University of Turin, Turin, Italy.
Abstract
OBJECTIVE: The aim of this study was to translate new evidence about management of spinal metastases in a practical and reliable score for surgeons, radiation oncologists and oncologists, able to establish the need for surgery regardless the available technology and settings. PATIENTS AND METHODS: Three main items were identified and graded: Neurological status (0-5 points), Stability of the spine according to the Spinal Instability Neoplastic Score (SINS) Score (0-5 points), and Epidural compression according to the Epidural Spinal Cord Compression (ESCC) scale (0-3 points). Patients were considered suitable for surgery with ASA score < 4 and ECOG score <3. A retrospective clinical validation of the NSE score was made on 145 patients that underwent surgical or non surgical treatment. RESULTS: Agreement between the undertaken treatment and the score (88.3% of patients), resulted in a strong association with improvement or preservation of clinical status (neurological functions and mechanical pain) (p < 0.001) at 3 and 6 months. In the non-agreement group no association was recorded at the 3 and 6 months follow-up (p 0.486 and 0.343 for neurological functions, 0.063 and 0.858 for mechanical pain). CONCLUSION: Functional outcomes of the study group showed that the proposed NSE score could represent a practical and reliable tool to establish the need for surgery. Agreement between the score and the performed treatments resulted in better clinical outcomes, when compared with patients without agreement. Further validation is needed with a larger number of patients and to assess reproducibility among surgeons, radiation oncologists, and oncologists.
OBJECTIVE: The aim of this study was to translate new evidence about management of spinal metastases in a practical and reliable score for surgeons, radiation oncologists and oncologists, able to establish the need for surgery regardless the available technology and settings. PATIENTS AND METHODS: Three main items were identified and graded: Neurological status (0-5 points), Stability of the spine according to the Spinal Instability Neoplastic Score (SINS) Score (0-5 points), and Epidural compression according to the Epidural Spinal Cord Compression (ESCC) scale (0-3 points). Patients were considered suitable for surgery with ASA score < 4 and ECOG score <3. A retrospective clinical validation of the NSE score was made on 145 patients that underwent surgical or non surgical treatment. RESULTS: Agreement between the undertaken treatment and the score (88.3% of patients), resulted in a strong association with improvement or preservation of clinical status (neurological functions and mechanical pain) (p < 0.001) at 3 and 6 months. In the non-agreement group no association was recorded at the 3 and 6 months follow-up (p 0.486 and 0.343 for neurological functions, 0.063 and 0.858 for mechanical pain). CONCLUSION: Functional outcomes of the study group showed that the proposed NSE score could represent a practical and reliable tool to establish the need for surgery. Agreement between the score and the performed treatments resulted in better clinical outcomes, when compared with patients without agreement. Further validation is needed with a larger number of patients and to assess reproducibility among surgeons, radiation oncologists, and oncologists.
Authors: F Cofano; G Di Perna; A Alberti; B M Baldassarre; M Ajello; N Marengo; F Tartara; F Zenga; D Garbossa Journal: J Bone Oncol Date: 2020-11-10 Impact factor: 4.072
Authors: Giuseppe Di Perna; Fabio Cofano; Cristina Mantovani; Serena Badellino; Nicola Marengo; Marco Ajello; Ludovico Maria Comite; Giuseppe Palmieri; Fulvio Tartara; Francesco Zenga; Umberto Ricardi; Diego Garbossa Journal: J Bone Oncol Date: 2020-09-26 Impact factor: 4.072
Authors: Arthur Wagner; Elena Haag; Ann-Kathrin Joerger; Philipp Jost; Stephanie E Combs; Maria Wostrack; Jens Gempt; Bernhard Meyer Journal: Sci Rep Date: 2021-04-12 Impact factor: 4.379
Authors: Bianca Maria Baldassarre; Federica Penner; Luca Bertero; Giuseppe Di Perna; Marco Ajello; Nicola Marengo; Francesco Zenga; Diego Garbossa Journal: Surg Neurol Int Date: 2021-03-30
Authors: Fabio Cofano; Giuseppe Di Perna; Fulvio Tartara; Nicola Marengo; Marco Ajello; Marco Bozzaro; Francesco Zenga; Diego Garbossa Journal: World Neurosurg Date: 2021-07 Impact factor: 2.104