Prognostic Discrepancy on Overall Survival Between Ambulatory and Nonambulatory Patients with Metastatic Spinal Cord Compression

Feng, Jiangtao; Yang, Xiong‐gang; Wang, Feng; Hua, Kun‐chi; Liu, Yong-Heng; Hu, Yongcheng; Zhang, Hao; Yang, Li; Xu, Ming‐you

doi:10.1016/j.wneu.2018.09.102

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…[6,7] It is well known that survival of the metastatic spinal tumor is dependent on the primary tumor. [13,15] We also found that the survival rate is affected by the clinical characteristics of the primary tumor rather than by the surgical methods. Although the surgical method does not entirely affect survival, it plays an essential role in controlling the tumor efficiently.…”

Section: Discussionmentioning

confidence: 76%

Surgical strategy for metastatic spinal tumor patients with surgically challenging situation

Shin

Kim²,

Lee

et al. 2022

Medicine

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The incidence of spinal metastasis is increasing as cancer patients live longer owing to the improvement of cancer treatments. However, traditional surgery (TS) which fixates at least 2 levels above and 2 levels below the affected vertebrae is sometimes difficult to perform as it is burdensome to the patients. In this article, we introduce our experience and strategy in treating spinal metastasis, focusing particularly on challenging cases. We retrospectively reviewed the data of 110 patients who underwent spinal surgery for metastatic spinal tumors from April 2018 to March 2020. Among them, 5 patients who received anterior approach surgery were excluded. The remaining 105 patients were enrolled. In addition to TS, we also performed cervical pedicle screw, cervicothoracic junction fixation, thoracolumbar short fixation, and decompression surgery, depending on the characteristics of the tumor. The overall survival was analyzed, and the local tumor control rate was evaluated using magnetic resonance imaging. Perioperative clinical characteristics including Spine Oncology Study Group Outcomes Questionnaire, visual analog scale, Eastern Cooperative Oncology Group performance score, and Karnofsky Performance Score were also investigated. The overall survival rate was 57.9% at 1 year, and the local tumor control rate was 81.1% after surgery. There was a statistically significant difference according to the type of the tumor in the survival analysis: the overall survival rates were 72.7% for favorable tumors and 48.6% for unfavorable tumors at 12 months after surgery (P = .04). Spine Oncology Study Group Outcomes Questionnaire, visual analog scale, Eastern Cooperative Oncology Group performance score, and Karnofsky Performance Score was improved after surgery. All surgical methods, including TS, cervical pedicle screw, cervicothoracic junction fixation, thoracolumbar short fixation, and decompression surgery, showed good clinical and radiological outcomes. Optimized surgical methods show similarly good clinical outcomes in managing spinal metastasis as TS.

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Section: Discussionmentioning

confidence: 76%

Surgical strategy for metastatic spinal tumor patients with surgically challenging situation

Shin

Kim²,

Lee

et al. 2022

Medicine

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“…Outras variáveis, como metástases viscerais, capacidade de deambulação e sexo, são amplamente discutidas em estudos que abordam SCMM 24,[27][28][29][30] . Em uma recente metanálise, foi sugerido que a metástase visceral é um importante fator prognóstico e apresenta um maior impacto para sobrevida para pacientes com câncer de pulmão e câncer de próstata 27 .…”

Section: Discussionunclassified

“…Em um estudo multicêntrico que abordou pacientes submetidos à radioterapia, foi demonstrado que pacientes que não deambulavam antes da primeira sessão de radioterapia apresentavam maior chance de morte precoce 24 . Por outro lado, Feng et al observaram que a deambulação era um preditor significativo para sobrevida somente na análise univariada, demonstrando resultado similar ao presente estudo 30 .…”

Section: Discussionunclassified

Fatores Prognósticos e Funcionalidade na Síndrome de Compressão Medular Metastática: um Estudo de Coorte

Faria¹,

Araujo²,

Chelles

et al. 2022

Rev. Bras. Cancerol.

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Introdução: A síndrome de compressão medular metastática (SCMM) tem grande potencial de perda irreversível da função motora e sensitiva, sendo considerada uma emergência oncológica. Objetivo: Avaliar o prognostico da SCMM e a funcionalidade dos pacientes com tumores sólidos. Método: Estudo de coorte que incluiu pacientes com câncer que desenvolveram SCMM entre janeiro de 2017 e dezembro de 2018. Os dados clínicos e sociodemográficos foram extraídos dos prontuários físicos e eletrônicos. Analise de sobrevida foi realizada pelo método Kaplan-Meier. Resultados: O estudo abrangeu 90 pacientes que apresentaram SCMM. Ao diagnostico da SCMM, 55,5% dos pacientes não conseguiam realizar marcha. Os pacientes com SCMM após câncer de pulmão tiveram 4,1 vezes maior risco de morrer (IC 95%, 1,79-9,41; p=0,001), os pacientes com tumores geniturinários tiveram 1,9 vezes maior risco de morrer (IC 95%, 1,06-3,45; p=0,02) e os pacientes com outros tipos de tumor tiveram 3,1 vezes maior risco de morrer (IC 95%, 1,58-6,24; p=0,001) quando comparados aos pacientes com SCMM após câncer de mama. Conclusão: Destaca-se a relevância clinica deste estudo ao descobrir que o tipo de tumor primário e um fator preditor independente para sobrevida da SCMM. Ao diagnostico da SCMM, mais da metade dos pacientes não realizam marcha.

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“…23 Several comparisons between the Tohuhashi and Tomita scores were reported, and found the Tokuhashi score to be superior. 21,24,25 The Tomita score is patient-centered, and places emphasis on the biology of the primary tumor, which would explain why it maintains predictive values even when specific tumor subtypes are evaluated. 21,26 The primary tumor type, the patient's general medical condition, and the level of metastasis are the main factors in most survival scores, but each of these components has unique weakness (Chen).…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

et al. 2020

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Objective To compare Tokuhashi and Tomita scores in patients with epidural spinal metastasis who underwent surgical treatment. Methods A retrospective evaluation of 103 patients with spinal metastasis and epidural compression who underwent surgical treatment. An analysis was performed of agreement between the survival rates observed in the study sample and the survival rate estimated by the Tomita and Tokuhashi scales. Results The overall accuracy was 39.03% for the Tomita scale and 61.75% for the Tokuhashi scale. Fair agreement (0.38 weighted Cohen’s Kappa coefficient) was observed between patient survival and the Tokuhashi score, and slight agreement (0.25 weighted Kappa coefficient) for the Tomita score. The agreement for both scales was higher for patients with less than six months’ survival, with general accuracy of 79.17% for the Tomita and 70.59% for the Tokuhashi scoring system. Conclusion There was fair and slight agreement between the Tokuhashi and Tomita scores with patient survival group. The agreement was higher for patients with less than six months’ survival. Level of evidence III; Comparative retrospective study.

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Prognostic Discrepancy on Overall Survival Between Ambulatory and Nonambulatory Patients with Metastatic Spinal Cord Compression

Cited by 7 publications

References 24 publications

Surgical strategy for metastatic spinal tumor patients with surgically challenging situation

Surgical strategy for metastatic spinal tumor patients with surgically challenging situation

Fatores Prognósticos e Funcionalidade na Síndrome de Compressão Medular Metastática: um Estudo de Coorte

A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

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