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Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression

OBJECTIVE: To investigate whether visceral metastases have a significant impact on survival in patients with metastasis‐related spinal cord compression (MSCC), and to determine the difference in prognosis between patients with and without visceral metastases. METHODS: Three institutional databases w...

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Autores principales: Lun, Deng‐xing, Wang, Xiao‐dong, Ji, Yu‐dong, Hu, Yong‐cheng, Yang, Xiong‐gang, Yu, Xiu‐chun, Zhang, Guo‐chuan, Zhuang, Qing‐shan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595099/
https://www.ncbi.nlm.nih.gov/pubmed/30985091
http://dx.doi.org/10.1111/os.12465
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author Lun, Deng‐xing
Wang, Xiao‐dong
Ji, Yu‐dong
Hu, Yong‐cheng
Yang, Xiong‐gang
Yu, Xiu‐chun
Zhang, Guo‐chuan
Zhuang, Qing‐shan
author_facet Lun, Deng‐xing
Wang, Xiao‐dong
Ji, Yu‐dong
Hu, Yong‐cheng
Yang, Xiong‐gang
Yu, Xiu‐chun
Zhang, Guo‐chuan
Zhuang, Qing‐shan
author_sort Lun, Deng‐xing
collection PubMed
description OBJECTIVE: To investigate whether visceral metastases have a significant impact on survival in patients with metastasis‐related spinal cord compression (MSCC), and to determine the difference in prognosis between patients with and without visceral metastases. METHODS: Three institutional databases were searched to identify all patients who had undergone spinal surgery for spinal metastases between March 2002 and June 2010. Data on patient characteristics including pre‐ and post‐operative medical conditions, were collected from medical records or by telephone follow‐up. Survival data were obtained either from medical records or by searching a governmental cancer registry. RESULTS: The mean age of study patients was 59.6 ± 10.5 years (range, 18–84 years), of whom 102 were male and 67 female. The median and mean postoperative survival times were 7.0 ± 0.5 (95% CI 6.0–8.0) months and 12.6 ± 1.2 (95% CI 10.1–15.0) months, respectively, in all patients, being 5.0 ± 0.5 (95% CI 4.0–6.0) months and 10.8 ± 2.4 (95% CI 6.1–15.5) months, respectively, for patients with visceral metastases and 7.0 ± 0.8 (95% CI 5.4–8.6) months and 13.0 ± 1.4 (95%CI 10.3–15.6) months, respectively, for patients without visceral metastases (P = 0.87). These survival times did not differ significantly between groups. Multivariate Cox proportional hazard regressions showed that visceral metastases had no statistically significant association with survival (P = 0.277), whereas rate of growth of primary tumor (P = 0.003), preoperative Karnofsky performance status (KPS) (P < 0.001), change in KPS (P < 0.001), and Frankel grade (P = 0.091) were independent prognostic factors in the whole cohort (P = 0.005). Changes in KPS (P = 0.001) and major complications (P = 0.003) were significantly associated with survival in patients with visceral metastases, whereas rate of growth of primary tumor (P = 0.016), change in KPS (P = 0.001), and preoperative KPS (P < 0.001) were significantly associated with survival in patients without visceral metastases. CONCLUSIONS: Visceral metastases do not appear to predict the prognosis of patients with MSCC; thus, more aggressive surgery should be considered in patients with MSCC who have visceral metastases. Additionally, prognostic factors differ according to visceral metastases status in these patients.
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spelling pubmed-65950992019-09-10 Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression Lun, Deng‐xing Wang, Xiao‐dong Ji, Yu‐dong Hu, Yong‐cheng Yang, Xiong‐gang Yu, Xiu‐chun Zhang, Guo‐chuan Zhuang, Qing‐shan Orthop Surg Clinical Articles OBJECTIVE: To investigate whether visceral metastases have a significant impact on survival in patients with metastasis‐related spinal cord compression (MSCC), and to determine the difference in prognosis between patients with and without visceral metastases. METHODS: Three institutional databases were searched to identify all patients who had undergone spinal surgery for spinal metastases between March 2002 and June 2010. Data on patient characteristics including pre‐ and post‐operative medical conditions, were collected from medical records or by telephone follow‐up. Survival data were obtained either from medical records or by searching a governmental cancer registry. RESULTS: The mean age of study patients was 59.6 ± 10.5 years (range, 18–84 years), of whom 102 were male and 67 female. The median and mean postoperative survival times were 7.0 ± 0.5 (95% CI 6.0–8.0) months and 12.6 ± 1.2 (95% CI 10.1–15.0) months, respectively, in all patients, being 5.0 ± 0.5 (95% CI 4.0–6.0) months and 10.8 ± 2.4 (95% CI 6.1–15.5) months, respectively, for patients with visceral metastases and 7.0 ± 0.8 (95% CI 5.4–8.6) months and 13.0 ± 1.4 (95%CI 10.3–15.6) months, respectively, for patients without visceral metastases (P = 0.87). These survival times did not differ significantly between groups. Multivariate Cox proportional hazard regressions showed that visceral metastases had no statistically significant association with survival (P = 0.277), whereas rate of growth of primary tumor (P = 0.003), preoperative Karnofsky performance status (KPS) (P < 0.001), change in KPS (P < 0.001), and Frankel grade (P = 0.091) were independent prognostic factors in the whole cohort (P = 0.005). Changes in KPS (P = 0.001) and major complications (P = 0.003) were significantly associated with survival in patients with visceral metastases, whereas rate of growth of primary tumor (P = 0.016), change in KPS (P = 0.001), and preoperative KPS (P < 0.001) were significantly associated with survival in patients without visceral metastases. CONCLUSIONS: Visceral metastases do not appear to predict the prognosis of patients with MSCC; thus, more aggressive surgery should be considered in patients with MSCC who have visceral metastases. Additionally, prognostic factors differ according to visceral metastases status in these patients. John Wiley & Sons Australia, Ltd 2019-04-15 /pmc/articles/PMC6595099/ /pubmed/30985091 http://dx.doi.org/10.1111/os.12465 Text en © 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Articles
Lun, Deng‐xing
Wang, Xiao‐dong
Ji, Yu‐dong
Hu, Yong‐cheng
Yang, Xiong‐gang
Yu, Xiu‐chun
Zhang, Guo‐chuan
Zhuang, Qing‐shan
Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title_full Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title_fullStr Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title_full_unstemmed Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title_short Relationship Between Visceral Metastases and Survival in Patients with Metastasis‐related Spinal Cord Compression
title_sort relationship between visceral metastases and survival in patients with metastasis‐related spinal cord compression
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595099/
https://www.ncbi.nlm.nih.gov/pubmed/30985091
http://dx.doi.org/10.1111/os.12465
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