The emergence of new prognostic scores in lung cancer patients with spinal metastasis: A 12-year single-center retrospective study

Abstract

Objective: Lung cancer patients exhibit spinal metastases from a specific population, and with this study, we aimed to develop a model that can predict this particular group's survival. Methods: Data were retrospectively collected from 83 lung cancer patients who underwent spinal metastasis surgery at our center from 2009 to 2021. After the initial assessment of treatment and scoring effects, a nomogram for survival prediction was created by identifying and integrating critical prognostic factors, followed by a consistency index (C-index) to measure consistency, and finally, a subject working characteristic curve (ROC) to compare the predictive accuracy of the three existing models. Results: The mean postoperative survival was 14.7 months. Surgical treatment significantly improved the VAS and Frankel scores in lung cancer patients with spinal metastases. The revised Tokuhashi score underestimated the life expectancy of these patients. Six independent prognostic factors, including age, extraspinal bone metastasis foci, visceral metastasis, Frankel score, targeted therapy, and radiotherapy, were identified and incorporated into the model. Calibration curves for 3-, 6-, and 12-month overall survival showed a good concordance between predicted and actual risk. The nomogram C-index for the cohort study was 0.800 (95% confidence interval [CI]: 0.757-0.843). Model comparisons showed that the nomogram's prediction accuracy was better than revised Tokuhashi and Bauer's scoring systems. Conclusions: Spine surgery offered patients the possibility of regaining neurological function. Having identified shortcomings in existing scoring systems, we have recreated and validated a new nomogram that can be used to predict survival outcomes in patients with spinal metastases from lung cancer, thereby assisting spinal surgeons in making surgical decisions and personalizing treatment for these patients.

Procyanidin B2 regulates the Sirt1/Nrf2 signaling pathway to improve random‐pattern skin flap survival

“…Several studies have reported that activation of Sirt1 significantly reduces injury in various ischemic diseases. According to Chen et al, mangiferin exerts neuroprotective effects against cerebral IRI by activating SIRT1 (Chen, Chen, Zhou, et al, 2021). SIRT1's modulation of Nrf2 expression and activity is critical for regulating the cellular response to OS, as its upregulation enhances downstream antioxidant enzyme expression while its downregulation increases cellular susceptibility to OS (B. Zhang et al, 2018).…”

The Outcomes of Surgical and Nonsurgical Treatment in Patients With Spinal Metastases of Lung Cancer: Protocol for a Prospective Cohort Study

“…Truong et al [ 17 ] recruited patients with SMLC undergoing surgery and found that 14 (16%) out of 87 patients survived beyond 12 months. Chen et al [ 23 ] reported the median survival of their cohort to be 12 months; patients undergoing excisional surgery had a longer survival time than those with palliative surgery. Contrarily, in a systematic review by Armstrong et al [ 21 ], the authors reported unfavorable outcomes for surgical intervention, of which a shorter median OS was found in the surgical group compared to the nonsurgical group (7.5 months vs 8.5 months).…”

Case report: A balance of survival and quality of life in long-term survival case of lung adenocarcinoma with synchronous bone metastasis

“…The multidisciplinary approach conducted by the team of oncologists, orthopedic surgeons, radiologists, pathologists, psychologists, and palliative medicine specialists should be emphasized before the accurate prediction of survival. Several prognostic models were reported to predict the survival of lung patients with BM, which played an important role in treatment decision-making ( 8 , 20 – 22 ). For NSCLC patients with a predictive life expectancy of less than three months, best supportive care was recommended, which aimed to reduce suffering and support the best possible QOL ( 23 ).…”