Prognostic parameters and spinal metastases: a research study.

<h4>Object</h4>To identify pre-operative prognostic parameters for survival in patients with spinal epidural neoplastic metastasis when the primary tumour is unknown.<h4>Methods</h4>This study was a retrospective chart review of patients who underwent surgery for spinal epidu...

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Autores principales:	Jefferson W Daniel, José C E Veiga
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/183dd36e01bf49c5840f5e53076270c1
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spelling	oai:doaj.org-article:183dd36e01bf49c5840f5e53076270c12021-11-25T05:56:57ZPrognostic parameters and spinal metastases: a research study.1932-620310.1371/journal.pone.0109579https://doaj.org/article/183dd36e01bf49c5840f5e53076270c12014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0109579https://doaj.org/toc/1932-6203<h4>Object</h4>To identify pre-operative prognostic parameters for survival in patients with spinal epidural neoplastic metastasis when the primary tumour is unknown.<h4>Methods</h4>This study was a retrospective chart review of patients who underwent surgery for spinal epidural neoplastic metastases between February 1997 and January 2011. The inclusion criteria were as follows: known post-operative survival period, a Karnofsky Performance Score equal to or greater than 30 points and a post-operative neoplastic metastasis histological type. The Kaplan-Meier method was used to estimate post-operative survival, and the Log-Rank test was used for statistical inference.<h4>Results</h4>A total of 52 patients who underwent 52 surgical procedures were identified. The mean age at the time of spinal surgery was 53.92 years (std. deviation, 19.09). The median survival after surgery was 70 days (95% CI 49.97-90.02), and post-operative mortality occurred within 6 months in 38 (73.07%) patients. Lung cancer, prostate cancer, myeloma and lymphoma, the 4 most common primary tumour types, affected 32 (61.53%) patients. The three identified prognostic parameters were the following: pre-operative walking incapacity (American Spinal Injury Association, A and B), present in 86.53% of the patients (p-value = 0.107); special care dependency (Karnofsky Performance Score, 10-40 points), present in 90.38% of the patients (p-value = 0.322); and vertebral epidural neoplastic metastases that were in contact with the thecal sac (Weinstein-Boriani-Biagini, sector D), present in 94.23% of the patients (p-value = 0.643). When the three secondary prognostic parameters were combined, the mean post-operative survival was 45 days; when at least one was present, the survival was 82 days (p-value = 0.175).<h4>Conclusions</h4>Walking incapacity, special care dependency and contact between the neoplastic metastases and the thecal sac can help determine the ultimate survival of this patient population and, potentially, which patients would benefit from surgery versus palliation alone. A 2- to 3-month post-operative survival period justified surgical treatment.Jefferson W DanielJosé C E VeigaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 10, p e109579 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jefferson W Daniel José C E Veiga Prognostic parameters and spinal metastases: a research study.
description	<h4>Object</h4>To identify pre-operative prognostic parameters for survival in patients with spinal epidural neoplastic metastasis when the primary tumour is unknown.<h4>Methods</h4>This study was a retrospective chart review of patients who underwent surgery for spinal epidural neoplastic metastases between February 1997 and January 2011. The inclusion criteria were as follows: known post-operative survival period, a Karnofsky Performance Score equal to or greater than 30 points and a post-operative neoplastic metastasis histological type. The Kaplan-Meier method was used to estimate post-operative survival, and the Log-Rank test was used for statistical inference.<h4>Results</h4>A total of 52 patients who underwent 52 surgical procedures were identified. The mean age at the time of spinal surgery was 53.92 years (std. deviation, 19.09). The median survival after surgery was 70 days (95% CI 49.97-90.02), and post-operative mortality occurred within 6 months in 38 (73.07%) patients. Lung cancer, prostate cancer, myeloma and lymphoma, the 4 most common primary tumour types, affected 32 (61.53%) patients. The three identified prognostic parameters were the following: pre-operative walking incapacity (American Spinal Injury Association, A and B), present in 86.53% of the patients (p-value = 0.107); special care dependency (Karnofsky Performance Score, 10-40 points), present in 90.38% of the patients (p-value = 0.322); and vertebral epidural neoplastic metastases that were in contact with the thecal sac (Weinstein-Boriani-Biagini, sector D), present in 94.23% of the patients (p-value = 0.643). When the three secondary prognostic parameters were combined, the mean post-operative survival was 45 days; when at least one was present, the survival was 82 days (p-value = 0.175).<h4>Conclusions</h4>Walking incapacity, special care dependency and contact between the neoplastic metastases and the thecal sac can help determine the ultimate survival of this patient population and, potentially, which patients would benefit from surgery versus palliation alone. A 2- to 3-month post-operative survival period justified surgical treatment.
format	article
author	Jefferson W Daniel José C E Veiga
author_facet	Jefferson W Daniel José C E Veiga
author_sort	Jefferson W Daniel
title	Prognostic parameters and spinal metastases: a research study.
title_short	Prognostic parameters and spinal metastases: a research study.
title_full	Prognostic parameters and spinal metastases: a research study.
title_fullStr	Prognostic parameters and spinal metastases: a research study.
title_full_unstemmed	Prognostic parameters and spinal metastases: a research study.
title_sort	prognostic parameters and spinal metastases: a research study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/183dd36e01bf49c5840f5e53076270c1
work_keys_str_mv	AT jeffersonwdaniel prognosticparametersandspinalmetastasesaresearchstudy AT joseceveiga prognosticparametersandspinalmetastasesaresearchstudy
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Prognostic parameters and spinal metastases: a research study.

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