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Etli MU, Köylü RC, Sarikaya C, Sarıkaya H, Ramazanoglu AF, Şerifoğlu L, Yaltırık CK, Naderi S. Factors Affecting the Outcome of Spine Metastases: A Single-Center Evaluation in Surgically Treated Patients. World Neurosurg 2024:S1878-8750(24)01144-6. [PMID: 38972382 DOI: 10.1016/j.wneu.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND The estimation of survival is extremely important for metastatic disease in the spine. The aim of this study was to determine the factors affecting the outcome of patients with spinal metastasis, primarily the character of neurologic deficit and the histopathology of the tumor. METHOD A retrospective examination was made of 158 patients with spinal metastasis who were followed up in our clinic between 2010 and 2020 and underwent surgical intervention. The patients were examined in respect of demographic characteristics, the primary tumor, comorbidities, preoperative-postoperative visual aAnalog scale scores, preoperative-postoperative neurologic examinations and neurologic deficit if present and ambulation status, postoperative survival duration, tumor localization, characteristics of the surgeries, complications, the Karnofsky Performance Scale, revised Tokuhashi, and Tomita scores. RESULTS Spinal metastasis was seen more frequently in males (72.8% male, 27.8% female). Male gender, multiple level involvement, intradural localization, and Karnofsky Performance Scale <70 were seen to cause a shorter survival time. Patients with a primary focus of hematologic malignancy, breast cancer, and lymphoma had a longer survival. The revised Tokuhashi and Tomita scores were observed to be successful in the prediction of survival. A decrease in postoperative visual analog scale score had a positive effect on functional survival. The absence of preoperative neurological deficit and the patient's ability for preoperative and postoperative ambulation affected survival positively. The overall survival period decreased in patients who were mobilized in the early postoperative period but became nonmobile in the late period, and in those who were nonmobile in both the early and late postoperative periods. CONCLUSIONS The neurologic and ambulatory status, the Tomita and Tokuhashi scores, intradural localization, and gender are the factors with a significant effect on prognosis.
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Affiliation(s)
- Mustafa Umut Etli
- Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Reha Can Köylü
- Department of Neurosurgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Caner Sarikaya
- Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Hüseyin Sarıkaya
- Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey.
| | - Ali Fatih Ramazanoglu
- Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Luay Şerifoğlu
- Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Cumhur Kaan Yaltırık
- Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Sait Naderi
- Department of Neurosurgery, İstanbul Brain and Spine Center, İstanbul, Turkey
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Vassiliou A, Osunronbi T, Enyioma S, Rago G, Karathanasi A, Ghose A, Sheriff M, Mikropoulos C, Sanchez E, Moschetta M, Chargari C, Rassy E, Boussios S. Prognostic Factors in Patients with Metastatic Spinal Cord Compression Secondary to Lung Cancer-A Retrospective UK Single-Centre Study. Cancers (Basel) 2023; 15:4432. [PMID: 37760402 PMCID: PMC10527546 DOI: 10.3390/cancers15184432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE Metastatic spinal cord compression (MSCC) is a severe complication of cancer that can lead to irreversible neurological impairment, necessitating prompt recognition and intervention. This retrospective, single-centre study aimed to determine the prognostic factors and survival rates among patients presenting with MSCC secondary to lung cancer. METHODS AND MATERIALS We identified 74 patients with epidural metastases-related spinal cord compression and a history of lung cancer through the electronic database of Medway Maritime Hospital in the United Kingdom (UK), spanning the period from April 2016 to September 2021. Among them, 39 were below 55 years old, while 35 were aged 55 years or older; 24 patients were diagnosed with small cell lung cancer (SCLC), and 50 patients had non-small cell lung cancer (NSCLC). RESULTS The median overall survival (OS) was 5.5 months, with 52 out of 74 patients dying within 6 months of diagnosis with MSCC. For the entire cohort, the statistically significant variables on multi-variate analysis were cancer type (NSCLC had improved OS), the number of involved vertebrae (one to two vertebrae involvement had improved OS), and the time taken to develop motor deficits (≤10 days to develop motor deficits had worsened OS). For the NSCLC cohort, the statistically significant variables on multivariate analysis were molecular alterations (patients with epidermal growth factor receptor (EGFR) mutation), pre-treatment ambulatory status, Eastern Cooperative Oncology Group (ECOG) performance status, and the time taken to develop motor deficits. CONCLUSIONS Within the entire cohort, patients diagnosed with NSCLC and spinal metastases affecting one to two vertebrae exhibited enhanced OS. Within the NSCLC subgroup, those with EGFR mutations who were ambulatory and possessed an ECOG performance status of 1-2 demonstrated improved OS. In both the entire cohort and the NSCLC subgroup, the development of motor deficits within a period of ≤10 days was associated with poor OS.
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Affiliation(s)
- Anna Vassiliou
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
| | - Temidayo Osunronbi
- Hull University Teaching Hospital NHS Foundation Trust, Hull HU1 3SA, UK
| | - Synthia Enyioma
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
| | - Gerardo Rago
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
| | - Afroditi Karathanasi
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
| | - Aruni Ghose
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
- Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
- Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London HA6 2RN, UK
| | - Matin Sheriff
- Department of Urology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
| | - Christos Mikropoulos
- Department of Medical Oncology, St Luke’s Cancer Centre, Royal Surrey Hospital, Guildford GU1 1EB, UK
| | - Elisabet Sanchez
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
| | - Michele Moschetta
- Novartis Institutes for BioMedical Research, CH-4056 Basel, Switzerland;
| | - Cyrus Chargari
- Department of Radiation Oncology, Pitié Salpêtrière University Hospital, 75013 Paris, France;
| | - Elie Rassy
- Department of Medical Oncology, Gustave Roussy Institut, 94805 Villejuif, France;
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK (E.S.)
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- Kent Medway Medical School, University of Kent, Canterbury CT2 7LX, UK
- AELIA Organization, 9th Km Thessaloniki–Thermi, 57001 Thessaloniki, Greece
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Faria EMD, Araujo BPD, Chelles PA, Giglio AG, Fabro EAN, Bizzo LV, Bergmann A, Thuler LCS, Silva GTD. Fatores Prognósticos e Funcionalidade na Síndrome de Compressão Medular Metastática: um Estudo de Coorte. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.2160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
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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De Meue E, Smeijers S, Langmans C, Clement PM, Depreitere B. Identifying new predictive factors for survival after surgery for spinal metastases: an exploratory in-depth retrospective analysis. Acta Clin Belg 2022; 77:606-615. [PMID: 33956576 DOI: 10.1080/17843286.2021.1925028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES In selected patients with symptomatic spinal metastasis from solid tumors, surgery improves quality of life. Since selection is key, inaccurate survival prognostication may result in poor decisions and outcomes. However, most prognostic scores suffer from suboptimal external validation and subsequent mediocre performance. This warrants the ongoing search for factors that better capture the oncological status. This exploratory study aims to identify new preoperative variables that predict survival. METHODS A retrospective analysis was conducted on 62 patients from a tertiary care referral center who underwent debulking and/or reconstruction surgery for spinal metastases between 2006 and 2018, and in whom detailed clinical, oncological, surgical and biochemical variables were collected. Univariate and multivariate analyses were performed for overall survival. RESULTS Median survival was 13.2 months. Multivariate analysis for overall survival identified that a higher number of organs with metastases, a shorter time to progression on the last line of systemic therapy before surgery (TTPbs), low serum albumin, high alkaline phosphatase, high C-reactive peptide (CRP), presence of brain metastasis and the index spinal level located in the cervical region were independently associated with shorter survival. CONCLUSION We confirmed previously known predictors and identified CRP and TTPbs as new variables that were strongly associated with survival. The latter variable may replace primary tumor type, as improved cancer treatments make the primary tumor type less relevant as a predictor. This study is exploratory and its findings need to be validated, preferably in large prospective multicenter studies that are aiming at improving existing models.
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Affiliation(s)
- Elisabeth De Meue
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Steven Smeijers
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Ciska Langmans
- Department of Medical Oncology, OLV Hospital, Aalst, Belgium
| | - Paul M. Clement
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Depreitere
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
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CORTEZ PAULOROGÉRIO. SPINAL METASTASIS: DIAGNOSIS, TREATMENT AND PROGNOSIS - INTEGRATIVE REVIEW FROM 2012 TO 2017. COLUNA/COLUMNA 2020. [DOI: 10.1590/s1808-185120201901192641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
ABSTRACT Care of the patient with spinal metastasis is challenging. The topic of this article is the treatment and prognosis of spinal metastases, aiming to enumerate and analyze literature that addresses this treatment and prognosis. The methodology used was an integrative review in the Virtual Health Library. Nineteen articles were identified demonstrating that there is research and scientific production in this area. The thematic units and their categories are: treatment decision - prognostic scales or clinical neurological evaluation; types of treatment - minimally invasive and/or traditional; and effectiveness of prognostic scales higher or lower probability of success, which provide insight into the different possibilities of patient evaluation and their applicability in practice. When making the diagnosis, planning the treatment, and establishing a prognosis, the professional must be in sync with current precepts and act based on the objective and subjective characteristics of the patients, such as beliefs and values, which although immeasurable, influence the survival and the effectiveness of treatment. Level of evidence I; Integrative Review.
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Affiliation(s)
- PAULO ROGÉRIO CORTEZ
- Universidade Federal Fluminense, Brazil; Hospital Estadual Azevedo Lima, Brazil; Hospital Federal do Andaraí, Brazil; Centro de Saúde da Coluna, Brazil
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da Silva GT, Bergmann A, Thuler LCS. Impact of Symptomatic Metastatic Spinal Cord Compression on Survival of Patients with Non-Small-Cell Lung Cancer. World Neurosurg 2017; 108:698-704. [DOI: 10.1016/j.wneu.2017.09.079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 01/05/2023]
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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 2017; 17:689-708. [PMID: 27988342 DOI: 10.1016/j.spinee.2016.12.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 11/10/2016] [Accepted: 12/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Incidence of symptomatic spinal metastasis has increased owing to improvement in treatment of the disease. One of the key factors that influences decision-making is expected patient survival. To our knowledge, no systematic reviews or meta-analysis have been conducted that review independent prognostic factors in spinal metastases. PURPOSE This study aimed to determine independent prognostic factors that affect outcome in patients with metastatic spine disease. STUDY DESIGN This is a systematic literature review and meta-analysis of publications for prognostic factors in spinal metastatic disease. PATIENT SAMPLE Pooled patient results from cohort and observational studies. OUTCOME MEASUREMENT Meta-analysis for poor prognostic factors as determined by hazard ratio (HR) and 95% confidential interval (95% CI). METHODS We systematically searched relevant publications in PubMed and Embase. The following search terms were used: ("'spinal metastases'" OR "'vertebral metastases'" OR ""spinal metastasis" OR 'vertebral metastases') AND ('"prognostic factors"' OR "'survival'"). Inclusion criteria were prospective and retrospective cohort series that report HR and 95% CI of independent prognostic factors from multivariate analysis. Two reviewers independently assessed all papers. The quality of included papers was assessed by using Newcastle-Ottawa Scale for cohort studies and publication bias was assessed by using funnel plot, Begg test, and Egger test. The prognostic factors that were mentioned in at least three publications were pooled. Meta-analysis was performed using HR and 95% CI as the primary outcomes of interest. Heterogeneity was assessed using the I2 method. RESULTS A total of 3,959 abstracts (1,382 from PubMed and 2,577 from Embase) were identified through database search and 40 publications were identified through review of cited publications. The reviewers selected a total of 51 studies for qualitative synthesis and 43 studies for meta-analysis. Seventeen poor prognostic factors were identified. These included presence of a neurologic deficit before surgery, non-ambulatory status before radiotherapy (RT), non-ambulatory status before surgery, presence of bone metastases, presence of multiple bone metastases (>2 sites), presence of multiple spinal metastases (>3 sites), development of motor deficit in <7 days before initiating RT, development of motor deficit in <14 days before initiating RT, time interval from cancer diagnosis to RT <15 months, Karnofsky Performance Score (KPS) 10-40, KPS 50-70, KPS<70, Eastern Cooperative Oncology Group (ECOG) grade 3-4, male gender, presence of visceral metastases, moderate growth tumor on Tomita score (TS) classification, and rapid growth tumor on TS classification. CONCLUSIONS Seventeen independent poor prognostic factors were identified in this study. These can be categorized into cancer-specific and nonspecific prognostic factors. A tumor-based prognostic scoring system that combines all specific and general factors may enhance the accuracy of survival prediction in patients with metastatic spine disease.
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Affiliation(s)
- Panya Luksanapruksa
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd Bangkoknoi, Bangkok 10700, Thailand
| | - Jacob M Buchowski
- Department of Orthopedic Surgery, Barnes-Jewish Institute of Health, Washington University in St. Louis, 425 S. Euclid Ave, Campus Box 8233, St. Louis, MO 63110, USA.
| | - William Hotchkiss
- Department of Orthopedic Surgery, Barnes-Jewish Institute of Health, Washington University in St. Louis, 425 S. Euclid Ave, Campus Box 8233, St. Louis, MO 63110, USA
| | - Sasima Tongsai
- Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok 10700, Thailand
| | - Sirichai Wilartratsami
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd Bangkoknoi, Bangkok 10700, Thailand
| | - Areesak Chotivichit
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd Bangkoknoi, Bangkok 10700, Thailand
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Chen YM, Fang YT, Lai CH, Rau KM, Huang CH, Chang HC, Chao TY, Tseng CC, Fang WF, Wang CC, Chen YC, Chung YH, Wang YH, Su MC, Liu SF, Huang KT, Chen HC, Chang YC, Chang YP, Lin MC. A Survival Scoring System for Non-Small Cell Lung Cancer Patients with De Novo Bone Metastases. PLoS One 2016; 11:e0167923. [PMID: 27930702 PMCID: PMC5145216 DOI: 10.1371/journal.pone.0167923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/22/2016] [Indexed: 01/18/2023] Open
Abstract
In the pre-tyrosine kinase inhibitors (TKIs) era, non-small cell lung cancer (NSCLC) patients with de novo bone metastases had a worse prognosis than those without. However, whether epidermal growth factor receptor (EGFR)-TKIs affect the outcomes of EGFR mutant NSCLC patients with de novo bone metastases has not been well studied thus far. We retrospectively studied the effect of EGFR mutation status and first-line EGFR-TKIs on patient outcomes and created a survival scoring system for NSCLC patients with de novo bone metastases. This retrospective study evaluated 1510 NSCLC patients diagnosed between November 2010 and March 2014. Among these patients, 234 patients had de novo bone metastases. We found that 121 of these 234 patients (51.7%) had positive EGFR mutation tests, and a positive EGFR mutation test significantly affected overall survival (OS) (EGFR mutant: 15.2 months, EGFR wild type: 6.5 months; p < 0.001). Other prognostic factors significant in the multivariable analysis for NSCLC with de novo bone metastases included Eastern Cooperative Oncology Group performance status (PS) (OS; PS 0–2: 11.2 months, PS 3–4: 4.9 months; p = 0.002), presence of extraosseous metastases (OS; with extraosseous metastases: 8.8 months, without extraosseous metastases: 14.0 months; p = 0.008), blood lymphocyte-to-monocyte ratio (LMR) (OS; LMR > 3.1: 17.1months, LMR ≤ 3.1: 6.9months; p < 0.001). A positive EGFR mutation status reversed the poor outcomes of NSCLC patients with de novo bone metastases. A simple and useful survival scoring system including the above clinical parameters was thus created for NSCLC patients with de novo bone metastases.
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Affiliation(s)
- Yu-Mu Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ying-Tang Fang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Hao Lai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kun-Ming Rau
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hua Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Huang-Chih Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tung-Ying Chao
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Cheng Tseng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Feng Fang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Chin-Chou Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Yung-Che Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Hsiu Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Hsi Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mao-Chang Su
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Feng Liu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Tung Huang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-Chen Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ya-Chun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Chih Lin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- * E-mail:
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Nieder C. Frühe oder verzögerte Einleitung einer Palliativbetreuung. Strahlenther Onkol 2015. [DOI: 10.1007/s00066-015-0853-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Prognostic factors in patients with metastatic spinal cord compression secondary to lung cancer: a systematic review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015. [DOI: 10.1007/s00586-015-4157-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Incidence, associated factors, and survival in metastatic spinal cord compression secondary to lung cancer. Spine J 2015; 15:1263-9. [PMID: 25687415 DOI: 10.1016/j.spinee.2015.02.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/15/2014] [Accepted: 02/06/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Bone metastasis (BM) occurs frequently in patients with lung cancer (LC). The most affected are the bones of the spine, increasing the risk of developing metastatic spinal cord compression (MSCC). Although MSCC is one of the most disabling complications, few studies have reported relevant results related to its frequency and prognosis among patients with LC. PURPOSE The purpose of this study was to determine the incidence and associated factors of the development of MSCC after BM with LC and its prognosis. STUDY DESIGN/SETTING This is a cohort study. PATIENT SAMPLE A cohort of 112 patients with BM because of LC, whose treatment was performed exclusively at the National Cancer Institute, was analyzed. OUTCOME MEASURES Study outcome measures included incidence of MSCC, factors associated with MSCC, and survival analysis. METHODS A cohort study was performed involving patients with BM because of LC diagnosed between 2007 and 2011. Clinical and sociodemographic data were extracted from the physical and electronic medical records because of initial diagnosis (up until December 2013). The association between the independent variables and the outcomes was performed by using crude and adjusted odds ratios (ORs), assuming 95% confidence intervals (CIs). For the exploratory evaluation between the independent variables and the time until the outcomes, Kaplan-Meier survival analysis was conducted. To identify if the differences between the curves were statistically significant, a log-tank test was calculated. A Cox multiple regression model, using the forward stepwise method, was applied, aiming to estimate the factors associated with time to death in the different exposure groups. RESULTS Of the 112 patients with BM, 31 (27.7%) developed MSCC. The univariate analysis showed that patients with three or more involved vertebrae revealed a 6.1 times greater risk of developing MSCC, compared with those with up to two metastatic vertebrae involved (OR: 6.1, 95% CI: 2.5-15.1, p<.001). Among the patients who developed MSCC, the median survival time was 4.4 months (95% CI: 1.5-7.3) and 4.7 months (95% CI: 3.5-5.9) in the patients without MSCC, not being a statistically significant difference (p=.19). After the occurrence of the MSCC, the median survival time was 2.8 months (95% CI: 1.4-4.1). CONCLUSIONS In this study, a high incidence of MSCC was observed in patients with BM. The study suggests that patients with three or more involved vertebrae per metastasis are more likely to develop MSCC. No alteration in the overall survival time was noticed among the patients with or without MSCC.
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Switlyk M, Kongsgaard U, Skjeldal S, Hald J, Hole K, Knutstad K, Zaikova O. Prognostic Factors in Patients with Symptomatic Spinal Metastases and Normal Neurological Function. Clin Oncol (R Coll Radiol) 2015; 27:213-21. [DOI: 10.1016/j.clon.2015.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 12/08/2014] [Accepted: 12/12/2014] [Indexed: 01/19/2023]
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