Age Is a Risk Factor for Postoperative Complications Following Excisional Laminectomy for Intradural Extramedullary Spinal Tumors

Phan, Kevin; Vig, Khushdeep S.; Ho, Yam Ting; Hussain, Awais K.; Capua, John Di; Kim, Jun; White, Samuel J.; Lee, Nathan J.; Kothari, Parth; Cho, Samuel K.

doi:10.1177/2192568218754512

Cited by 9 publications

(4 citation statements)

References 62 publications

(114 reference statements)

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“…Primary spinal cord tumor is rare in patients, and for this reason, the relevant statistics are still lacking ( 1 ). It was reported that the incidence of primary spinal cord tumor (PSCT) was 10–15 times less than that of primary intracranial tumors, which accounts for ~5–15% of all spinal tumors and 2–4% of all primary tumors of the central nervous systems (CNS) ( 2 , 3 ). According to the anatomical location, PSCT can be classified as extradural, intradural extramedullary, and intramedullary ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Personalized Prognostic Prediction Model for Patients With Spinal Cord Astrocytoma

Yang

Wang

et al. 2022

Front. Med.

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BackgroundThe study aimed to investigate the prognostic factors of spinal cord astrocytoma (SCA) and establish a nomogram prognostic model for the management of patients with SCA.MethodsPatients diagnosed with SCA between 1975 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training and testing datasets (7:3). The primary outcomes of this study were overall survival (OS) and cancer-specific survival (CSS). Cox hazard proportional regression model was used to identify the prognostic factors of patients with SCA in the training dataset and feature importance was obtained. Based on the independent prognostic factors, nomograms were established for prognostic prediction. Calibration curves, concordance index (C-index), and time-dependent receiver operating characteristic (ROC) curves were used to evaluate the calibration and discrimination of the nomogram model, while Kaplan-Meier (KM) survival curves and decision curve analyses (DCA) were used to evaluate the clinical utility. Web-based online calculators were further developed to achieve clinical practicability.ResultsA total of 818 patients with SCA were included in this study, with an average age of 30.84 ± 21.97 years and an average follow-up time of 117.57 ± 113.51 months. Cox regression indicated that primary site surgery, age, insurance, histologic type, tumor extension, WHO grade, chemotherapy, and post-operation radiotherapy (PRT) were independent prognostic factors for OS. While primary site surgery, insurance, tumor extension, PRT, histologic type, WHO grade, and chemotherapy were independent prognostic factors for CSS. For OS prediction, the calibration curves in the training and testing dataset illustrated good calibration, with C-indexes of 0.783 and 0.769. The area under the curves (AUCs) of 5-year survival prediction were 0.82 and 0.843, while 10-year survival predictions were 0.849 and 0.881, for training and testing datasets, respectively. Moreover, the DCA demonstrated good clinical net benefit. The prediction performances of nomograms were verified to be superior to that of single indicators, and the prediction performance of nomograms for CSS is also excellent.ConclusionsNomograms for patients with SCA prognosis prediction demonstrated good calibration, discrimination, and clinical utility. This result might benefit clinical decision-making and patient management for SCA. Before further use, more extensive external validation is required for the established web-based online calculators.

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Section: Introductionmentioning

confidence: 99%

Development and Validation of a Personalized Prognostic Prediction Model for Patients With Spinal Cord Astrocytoma

Yang

Wang

et al. 2022

Front. Med.

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“…11 Previous studies have investigated the outcomes of spinal tumor surgery and identified factors commonly associated with postoperative morbidity and mortality. [12][13][14][15][16][17][18][19][20][21][22][23] However, these studies were either retrospective institutional studies applicable only to specific groups of tumors or procedures [12][13][14]16,[18][19][20][21][22][23] or analyzed a limited number of predictors or outcome measures. [12][13][14][15][16][17][18][19][20][21]23 A comprehensive risk score that incorporates preoperative AE predictors could help surgeons anticipate major postoperative AEs.…”

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confidence: 99%

“…12-23 However, these studies were either retrospective institutional studies applicable only to specific groups of tumors or procedures 12-14,16,18-23 or analyzed a limited number of predictors or outcome measures. 12-21,23 A comprehensive risk score that incorporates preoperative AE predictors could help surgeons anticipate major postoperative AEs.…”

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Development and External Validation of the Spinal Tumor Surgery Risk Index

et al. 2023

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BACKGROUND: Patients undergoing surgical procedures for spinal tumors are vulnerable to major adverse events (AEs) and death in the postoperative period. Shared decision making and preoperative optimization of outcomes require accurate risk estimation. OBJECTIVE: To develop and validate a risk index to predict short-term major AEs after spinal tumor surgery. METHODS: Prospectively collected data from multiple medical centers affiliated with the American College of Surgeons National Surgical Quality Improvement Program from 2006 to 2020 were reviewed. Multiple logistic regression was used to assess sociodemographic, tumor-related, and surgery-related factors in the derivation cohort. The spinal tumor surgery risk index (STSRI) was built based on the resulting scores. The STSRI was internally validated using a subgroup of patients from the American College of Surgeons National Surgical Quality Improvement Program database and externally validated using a cohort from a single tertiary center. RESULTS: In total, 14 982 operations were reviewed and 4556 (16.5%) major AEs occurred within 30 days after surgery, including 209 (4.5%) deaths. 22 factors were independently associated with major AEs or death and were included in the STSRI. Using the internal and external validation cohorts, the STSRI produced an area under the curve of 0.86 and 0.82, sensitivity of 80.1% and 79.7%, and specificity of 74.3% and 73.7%, respectively. The STSRI, which is freely available, outperformed the modified frailty indices, the American Society of Anesthesiologists classification, and the American College of Surgeons risk calculator. CONCLUSION: In patients undergoing surgery for spinal tumors, the STSRI showed the highest predictive accuracy for major postoperative AEs and death compared with other current risk predictors.

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“…Ушкодження хребців в результаті неопластичних процесів призводить до тяжких наслідків стану здоров'я різного віку та статі [1,2]. Наслідком невірно обраної тактики лікування первинних та метастатичних уражень хребта є тяжкі ортопедо-неврологічні ускладнення і, навіть, летальний результат [3,4]. На теперішній час є можливим виконання об'єму хірургічного втручання від малоінвазивного до «total en block» [5,6].…”

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Main Types of Vertebrates in Spine Tumors (Prospective Study)

Korzh¹,

Kutsenko²,

Popov³

et al. 2021

Ukr. ž. med. bìol. sportu

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Damage to the vertebrae as a result of neoplastic processes leads to serious health consequences for people of all ages and genders. Unsuccessfully constructed tactics for the treatment of primary and metastatic spinal lesions are the result of severe orthopedic and neurological complications, which can lead to fatal consequences. To decide what type of surgery to perform, you need to have more information than the type of tumor. To create a rational algorithm for the treatment of patients with loss of spinal support due to neoplastic lesions of the thoracic and lumbar vertebrae should consider the features of damage to the anatomical structures of the spinal motor segment and identify the main types of vertebral injuries. The purpose of the study was based on a prospective analysis of patients with spinal cord injuries, and description of the types of vertebral injuries. Material and methods. In the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. In the period from 2008 to 2017, 264 patients with pathological changes in the spine were diagnosed. The age of patients was from 18 to 81 years. There were 137 men and 131 women. 39 (14.8%) patients did not have vertebral body deformity accompanied by bone edema, 168 (63.6%) patients had vertebral body damage without destruction of other anatomical structures, 52 (19.7%) patients were diagnosed with deformation of the vertebral body with damage to the arches and joints, and 5 (1.9%) patients had damage to the posterior support complex. Results and discussion. As a result of a prospective analysis of patients with spinal tumors, 5 types of vertebral lesions were identified by cancer: 1 – without deformation, accompanied by bone edema and visualized on MRI; 2 – deformation of the vertebral body up to 30% without damage to the posterior wall or with a small defect; 3 – deformation of the vertebral body > 30%, but < 60% with damage to the posterior vertebral wall; 4 – deformation of the vertebral body> 60% with damage to the posterior vertebral wall; 5 – deformation of the vertebral body with damage to the arches and joints. Conclusion. As a result of damage to the anatomical structures of the vertebrae by the tumor process, important morphological features were identified: the degree of damage to the vertebral body; the magnitude of local kyphosis; deformation of the posterior wall of the vertebral body, on the basis of which the types of vertebral injuries are determined

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Age Is a Risk Factor for Postoperative Complications Following Excisional Laminectomy for Intradural Extramedullary Spinal Tumors

Cited by 9 publications

References 62 publications

Development and Validation of a Personalized Prognostic Prediction Model for Patients With Spinal Cord Astrocytoma

Development and Validation of a Personalized Prognostic Prediction Model for Patients With Spinal Cord Astrocytoma

Development and External Validation of the Spinal Tumor Surgery Risk Index

Main Types of Vertebrates in Spine Tumors (Prospective Study)

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