Survival Time and Prognostic Factors in Patients with Spinal Metastases: A retrospective cohort and prognostic study
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Abstract
Purpose: To determine the survival time in patients with spinal metastases and identify the factors associated with survival time.
Methods: A retrospective cohort study of patients with spinal metastases treated at Maharat Nakhon Ratchasima Hospital between January 2009 and December 2013 was performed. The following assessment parameters were recorded: General demographic data, ambulatory status, the number of involved vertebrae, visceral organ metastases, lung metastases or lung tumor, known or unknown primary sites of metastases, surgical operation, radiotherapy and the survival period. The Kaplan-Meier survival analysis, the log-rank test and Cox proportional hazard regression model were used to determine the survival analysis.
Results: There were 119 patients included in the study; 62 were female. The mean age was 61 years old. The most common identified sites of primary tumor were lung, prostate, cervix, breast and multiple myeloma, but 47.9% were from unknown primary sites. The median survival time was 132 days. The multivariate survival analysis revealed statistically significant factors were: type of primary malignancy, evidence of lung metastases or lung cancer.
Conclusion: The prevalence of an unidentifiable primary site is high and the most common site is the lungs followed by the prostate. The presence of lung metastases or lung tumor were the factors that associated with poor patient survival.
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References
2. Rose PS, Buchowski JM. Metastatic disease in the thoracic and lumbar spine: evaluation and management. J Am Acad Orthop Surg 2011; 19: 37-48.
3. Hage WD, Aboulafia AJ, Aboulafia DM. Incidence, location, and diagnostic evaluation of metastatic bone disease. Orthop Clin North Am 2000; 31: 515-28.
4. Phanphaisarn A, Patumanond J, Settakorn J, Chaiyawat P, Klangjorhor J, Pruksakorn D. Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand. Asian Pac J Cancer Prev 2016; 17: 4335-40.
5. Paholpak P, Sirichativapee W, Wisanuyotin T, Kosuwon W, Jeeravipoolvarn P. Prevalence of known and unknown primary tumor sites in spinal metastasis patients. Open Orthop J 2012; 6: 440-4.
6. Kataoka M, Kunisada T, Tanaka M, Takeda K, Itani S, Sugimoto Y, et al. Statistical analysis of prognostic factors for survival in patients with spinal metastasis. Acta Med Okayama 2012; 66: 213-9.
7. Wibmer C, Leithner A, Hofmann G, Clar H, Kapitan M, Berghold A, et al. Survival Analysis of 254 Patients After Manifestation of Spinal Metastases: Evaluation of Seven Preoperative Scoring Systems. Spine (Phila Pa 1976) 2011; 36: 1977-86.
8. Mizumoto M, Harada H, Asakura H, Hashimoto T, Furutani K, Hashii H, et al. Prognostic factors and a scoring system for survival after radiotherapy for metastases to the spinal column: a review of 544 patients at Shizuoka Cancer Center Hospital. Cancer 2008; 113: 2816-22.
9. Rougraff BT, Kneisl JS, Simon MA. Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J Bone Joint Surg Am 1993; 75: 1276-81.
10. Leithner A, Radl R, Gruber G, Hochegger M, Leithner K, Welkerling H, et al. Predictive value of seven preoperative prognostic scoring systems for spinal metastases. Eur Spine J 2008; 17: 1488-95.
11. Rades D, Fehlauer F, Schulte R, Veninga T, Stalpers LJA, Basic H, et al. Prognostic Factors for Local Control and Survival After Radiotherapy of Metastatic Spinal Cord Compression. J Clin Oncol 2006; 24: 3388-93.
12. Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 2005; 30: 2186-91.
13. Tokuhashi Y, Uei H, Oshima M, Ajiro Y. Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop 2014; 5: 262-71.
14. Kumar N, Tan JJH, Zaw AS, Lim JL, Wai KL, Malhotra R, et al. Evaluation of scoring systems and prognostic factors in patients with spinal metastases from nasopharyngeal carcinoma. Spine J 2014; 14: 2946-53.
15. Luksanapruksa P, Buchowski JM, Hotchkiss W, Tongsai S, Wilartratsami S, Chotivichit A. Prognostic factors in patients with spinal metastasis: a systematic review and meta-analysis. Spine J 2016.
16. Rades D, Douglas S, Huttenlocher S, Veninga T, Bajrovic A, Rudat V, et al. Prognostic factors and a survival score for patients with metastatic spinal cord compression from colorectal cancer. Strahlenther Onkol 2012; 188: 1114-8.
17. Phanphaisarn A, Patumanond J, Settakorn J, Chaiyawat P, Klangjorhor J, Pruksakorn D. Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand. Asian Pac J Cancer Prev 2016; 17: 4335-40.
18. Lee BH, Kim T-H, Chong H-S, Moon E-S, Park J-O, Kim H-S, et al. Prognostic factor analysis in patients with metastatic spine disease depending on surgery and conservative treatment: review of 577 cases. Ann Surg Oncol 2013; 20: 40-6.