Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5470
Peer-review started: April 1, 2021
First decision: April 13, 2021
Revised: April 25, 2021
Accepted: April 26, 2021
Article in press: April 26, 2021
Published online: July 16, 2021
The spine is the most common location of metastatic diseases. Treating a metastatic spinal tumor depends on many factors, including patients’ overall health and life expectancy. The present study was conducted to investigate prognostic factors and clinical outcomes in patients with vertebral metastases.
To investigate prognostic factors and their predictive value in patients with metastatic spinal cancer.
A retrospective analysis of 109 patients with metastatic spinal cancer was conducted between January 2015 and September 2017. The prognoses and survival were analyzed, and the effects of factors such as clinical features, treatment methods, primary lesions and affected spinal segments on the prognosis of patients with metastatic spinal cancer were discussed. The prognostic value of Frankel spinal cord injury functional classification scale, metastatic spinal cord compression (MSCC), spinal instability neoplastic score (SINS) and the revised Tokuhashi score for prediction of prognosis was explored in patients with metastatic spinal tumors.
Age, comorbidity of metastasis from elsewhere, treatment methods, the number of spinal tumors, patient’s attitude toward tumors and Karnofsky performance scale score have an effect on the prognosis of patients (all P < 0.05). With respect to classification of spinal cord injury, before operation, the proportion of grade B and grade C was higher in the group of patients who died than in the group of patients who survived, and that of grade D and grade E was lower in the group of patients who died than in the group of patients who survived (all P < 0.05). At 1 mo after operation, the proportion of grade A, B and C was higher in the group of patients who died than in the group of patients who survived, and that of grade E was lower in patients in the group of patients who died than in the group of patients who survived (all P < 0.05). MSCC occurred in four (14.3%) patients in the survival group and 17 (21.0%) patients in the death group (P < 0.05). All patients suffered from intractable pain, dysfunction in spinal cord and even paralysis. The proportion of SINS score of 1 to 6 points was lower in the death group than in the survival group, and the proportion of SINS score of 7 to 12 points was higher in the death group than in the survival group (all P < 0.05). The proportion of revised Tokuhashi score of 0 to 8 points and 9 to 11 points were higher in the death group than in the survival group, and the proportion of revised Tokuhashi score of 12 to 15 points was lower in the death group than in the survival group (all P < 0.05). Frankel spinal cord injury functional classification scale, MSCC, SINS and revised Tokuhashi score were important factors influencing the surgical treatment of patients with metastatic spinal cancer (all P < 0.05).
Frankel spinal cord injury functional classification scale, MSCC, SINS and revised Tokuhashi score were helpful in predicting the prognosis of patients with metastatic spinal cancer.
Core Tip: Early detection and prompt management usually ensure a better prognosis for cancer patients. It is important to examine the prognostic factors that influence the prognosis of patients with metastatic spine tumors in order to determine the optimal treatment strategy. The present study showed that age, comorbidity of metastasis from elsewhere, therapies, number of spinal tumors, patient attitude toward tumors and Karnofsky performance score significantly influenced prognosis of patients with metastatic spine tumors. Moreover, Frankel spinal cord injury functional classification scale score, metastatic spinal cord compression, spinal instability neoplastic score and revised Tokuhashi score were important factors influencing the prognosis of this disease and the treatment selection.