A validated preoperative score predicting survival and functional outcome in lung cancer patients operated with posterior decompression and stabilization for metastatic spinal cord compression

Lei, Mingxing; Liu, Yaosheng; Yan, Liang; Tang, Chuanghao; Yang, Shaoxing; Liu, Shubin

doi:10.1007/s00586-015-4290-6

Cited by 32 publications

(37 citation statements)

References 20 publications

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“…2,3,5,7,15,18,19,21,25,28,[30][31][32]34,35,37,38,40,43 Of these, 16 studies were retrospective; 1 was a longitudinal observational study; 1 was a randomized, multiinstitutional, nonblinded trial; and 1 was a semiprospective study that included both retrospectively and prospectively collected data. Surgical interventions included decompression with and without instrumentation and radiotherapy.…”

Section: Predictors Of Survivalmentioning

confidence: 99%

“…7 Additionally, the authors noted that KPS was the strongest predictor of survival in the their hormonerefractory patients. 7 Lei et al 21 sought to establish a scoring system for survival and functional outcome among patients undergoing posterior decompression surgery for lung cancer metastatic to the spine. The authors found that preoperative ambulatory status (p < 0.01), visceral metastases (p < 0.001), and time to developing motor deficits (p < 0.001) were significant predictors of survival and were therefore included in the scoring system.…”

Section: Predictors Of Survivalmentioning

confidence: 99%

“…The authors found that preoperative ambulatory status (p < 0.01), visceral metastases (p < 0.001), and time to developing motor deficits (p < 0.001) were significant predictors of survival and were therefore included in the scoring system. 21 In a separate study, Lei et al 19 also created a scoring system to predict survival prognosis among patients with metastatic non-small cell lung cancer causing spinal cord compression who underwent surgical decompression. The authors included the following components as part of their scoring system: ECOG performance status (p = 0.02), number of involved verte- The median postop survival time did not significantly decrease w/ an increasing no.…”

Section: Predictors Of Survivalmentioning

confidence: 99%

“…5,6,12,17,21,34,36,41 Seven studies were retrospective and one was a nonrandomized, prospective study. The 7 retrospective studies used different decompression techniques, and the prospective study used a minimally invasive approach.…”

Section: Neurological Functionmentioning

confidence: 99%

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Decompression surgery for spinal metastases: a systematic review

Bakar

Tanenbaum

Phan

et al. 2016

FOC

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OBJECTIVE The aim of this study was to systematically review the literature on reported outcomes following decompression surgery for spinal metastases. METHODS The authors conducted MEDLINE, Scopus, and Web of Science database searches for studies reporting clinical outcomes and complications associated with decompression surgery for metastatic spinal tumors. Both retrospective and prospective studies were included. After meeting inclusion criteria, articles were categorized based on the following reported outcomes: survival, ambulation, surgical technique, neurological function, primary tumor histology, and miscellaneous outcomes. RESULTS Of the 4148 articles retrieved from databases, 36 met inclusion criteria. Of those included, 8 were prospective studies and 28 were retrospective studies. The year of publication ranged from 1992 to 2015. Study size ranged from 21 to 711 patients. Three studies found that good preoperative Karnofsky Performance Status (KPS ≥ 80%) was a significant predictor of survival. No study reported a significant effect of time-to-surgery following the onset of spinal cord compression symptoms on survival. Three studies reported improvement in neurological function following surgery. The most commonly cited complication was wound infection or dehiscence (22 studies). Eight studies reported that preoperative ambulatory or preoperative motor status was a significant predictor of postoperative ambulatory status. A wide variety of surgical techniques were reported: posterior decompression and stabilization, posterior decompression without stabilization, and posterior decompression with total or subtotal tumor resection. Although a wide range of functional scales were used to assess neurological outcomes, four studies used the American Spinal Injury Association (ASIA) Impairment Scale to assess neurological function. Four studies reported the effects of radiation therapy and local disease control for spinal metastases. Two studies reported that the type of treatment was not significantly associated with the rate of local control. The most commonly reported primary tumor types included lung cancer, prostate cancer, breast cancer, renal cancer, and gastrointestinal cancer. CONCLUSIONS This study reports a systematic review of the literature on decompression surgery for spinal metastases. The results of this study can help educate surgeons on the previously published predictors of outcomes following decompression surgery for metastatic spinal disease. However, the authors also identify significant gaps in the literature and the need for future studies investigating the optimal practice with regard to decompression surgery for spinal metastases.

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Section: Predictors Of Survivalmentioning

confidence: 99%

Section: Predictors Of Survivalmentioning

confidence: 99%

Section: Predictors Of Survivalmentioning

confidence: 99%

Section: Neurological Functionmentioning

confidence: 99%

See 2 more Smart Citations

Decompression surgery for spinal metastases: a systematic review

Bakar

Tanenbaum

Phan

et al. 2016

FOC

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“…Predicting functional outcome is of great importance when selecting the appropriate treatment in MESCC patients [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

New imaging characteristics for predicting postoperative neurologic status in patients with metastatic epidural spinal cord compression. A retrospective analysis of 81 cases

et al. 2017

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BACKGROUND CONTEXT: Several clinical features have been proposed for the prediction of postoperative functional outcome in patients with metastatic epidural spinal cord compression (MESCC). However, few articles address the relationship between preoperative imaging characteristics and the postoperative neurologic status. PURPOSE:This study aims to analyze the postoperative functional outcome and to identify new imaging parameters for predicting postoperative neurologic status in patients with MESCC. STUDY DESIGN:This study is a retrospective consecutive case series of patients with MESCC who were treated surgically. PATIENT SAMPLE:We assessed 81 consecutive patients who were treated with decompressive surgery for MESCC between 2013 and 2015. OUTCOME MEASURES: Eight imaging characteristics were analyzed for postoperative motor status by logistic regression models. Neurologic function was assessed using the Frankel grade preoperatively and postoperatively. METHODS:The following imaging characteristics were assessed for postoperative motor status: location of lesions in the spine, lamina involvement, retropulsion of the posterior wall, number of vertebrae involved, pedicle involvement, fracture of any involved vertebrae, T2 signal of the spinal cord at the compression site, and circumferential angle of spinal cord compression (CASCC). RESULTS:The postoperative neurologic outcome was better than the preoperative neurologic status (p<.01). In the entire group, 40.7% of the patients were non-ambulatory before the surgical procedure, whereas 77.8% of the patients could walk after surgery (p=.01). In the multivariate analysis, the location of the lesions (odds ratio [OR]: 3.89, 95% confidence interval [CI]: 1.19-12.77, p=.02) and CASCC (OR: 2.31, 95% CI: 1.44-3.71, p<.01) were significantly associated with postoperative neurologic outcome. A CASCC of more than 180°was associated with an increased OR that approached significance, and the larger the CASCC, the higher the risk of poor postoperative neurologic status.

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The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2016

Benoist

2016

Eur Spine J

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A validated preoperative score predicting survival and functional outcome in lung cancer patients operated with posterior decompression and stabilization for metastatic spinal cord compression

Cited by 32 publications

References 20 publications

Decompression surgery for spinal metastases: a systematic review

Decompression surgery for spinal metastases: a systematic review

New imaging characteristics for predicting postoperative neurologic status in patients with metastatic epidural spinal cord compression. A retrospective analysis of 81 cases

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2016

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