Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study

OBJECTIVES: To compare survival after surgery for patients with spinal metastatic disease with known primary tumour (KPT) versus patients with unknown primary tumour (UPT). PARTICIPANTS: 393 patients 18 years or older (270 men and 123 women, mean age 67.3 years) undergoing surgery at Uppsala Univers...

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Autores principales: Carrwik, Christian, Olerud, Claes, Robinson, Yohan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388281/
https://www.ncbi.nlm.nih.gov/pubmed/34433605
http://dx.doi.org/10.1136/bmjopen-2021-050538
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author Carrwik, Christian
Olerud, Claes
Robinson, Yohan
author_facet Carrwik, Christian
Olerud, Claes
Robinson, Yohan
author_sort Carrwik, Christian
collection PubMed
description OBJECTIVES: To compare survival after surgery for patients with spinal metastatic disease with known primary tumour (KPT) versus patients with unknown primary tumour (UPT). PARTICIPANTS: 393 patients 18 years or older (270 men and 123 women, mean age 67.3 years) undergoing surgery at Uppsala University Hospital in Swedenbetween 2006 and 2016due to spinal metastatic disease. 271 patients (69%) had a KPT at the time of surgery and 122 (31%) had an UPT. INTERVENTIONS: Decompressive and/or stabilising spine surgery due to spinal metastatic disease. PRIMARY OUTCOME: Survival (median and mean) after surgery. RESULTS: The estimated median survival time after surgery for patients with KPT was 7.4 months (95% CI 6.0 to 8.7) and mean survival time was 21.6 months (95% CI 17.2 to 26.0). For patients with UPT, the median estimated survival time after surgery was 15.6 months (95% CI 7.5 to 23.7) and the mean survival time was 48.1 months (95% CI 37.3 to 59.0) (Breslow, p=0.001). Unknown primary cancer was a positive predictor of survival after surgery (Cox regression, HR=0.58, 95% CI 0.46 to 0.73). CONCLUSION: In this study, patients with spinal metastasis and UPT had a longer expected survival after surgery compared with patients with KPT. This suggests that patients with UPT and spinal metastasis should not be withheld from surgery only based on the fact that the primary tumour is unknown.
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spelling pubmed-83882812021-09-14 Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study Carrwik, Christian Olerud, Claes Robinson, Yohan BMJ Open Surgery OBJECTIVES: To compare survival after surgery for patients with spinal metastatic disease with known primary tumour (KPT) versus patients with unknown primary tumour (UPT). PARTICIPANTS: 393 patients 18 years or older (270 men and 123 women, mean age 67.3 years) undergoing surgery at Uppsala University Hospital in Swedenbetween 2006 and 2016due to spinal metastatic disease. 271 patients (69%) had a KPT at the time of surgery and 122 (31%) had an UPT. INTERVENTIONS: Decompressive and/or stabilising spine surgery due to spinal metastatic disease. PRIMARY OUTCOME: Survival (median and mean) after surgery. RESULTS: The estimated median survival time after surgery for patients with KPT was 7.4 months (95% CI 6.0 to 8.7) and mean survival time was 21.6 months (95% CI 17.2 to 26.0). For patients with UPT, the median estimated survival time after surgery was 15.6 months (95% CI 7.5 to 23.7) and the mean survival time was 48.1 months (95% CI 37.3 to 59.0) (Breslow, p=0.001). Unknown primary cancer was a positive predictor of survival after surgery (Cox regression, HR=0.58, 95% CI 0.46 to 0.73). CONCLUSION: In this study, patients with spinal metastasis and UPT had a longer expected survival after surgery compared with patients with KPT. This suggests that patients with UPT and spinal metastasis should not be withheld from surgery only based on the fact that the primary tumour is unknown. BMJ Publishing Group 2021-08-24 /pmc/articles/PMC8388281/ /pubmed/34433605 http://dx.doi.org/10.1136/bmjopen-2021-050538 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Surgery
Carrwik, Christian
Olerud, Claes
Robinson, Yohan
Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title_full Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title_fullStr Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title_full_unstemmed Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title_short Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study
title_sort does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? a retrospective longitudinal cohort study
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388281/
https://www.ncbi.nlm.nih.gov/pubmed/34433605
http://dx.doi.org/10.1136/bmjopen-2021-050538
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