Survival in Patients With Spinal Metastatic Disease Treated Nonoperatively With Radiotherapy: Are the SORG-ML Algorithms Relevant?

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Clinical Spine Surgery Pub Date : 2024-08-01 Epub Date: 2024-02-02 DOI:10.1097/BSD.0000000000001575

Brian P Fenn, Aditya V Karhade, Olivier Q Groot, Austin K Collins, Tracy A Balboni, Kevin S Oh, Marco L Ferrone, Joseph H Schwab

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Abstract

Summary of background data: The SORG-ML algorithms for survival in spinal metastatic disease were developed in patients who underwent surgery and were externally validated for patients managed operatively.

Objective: To externally validate the SORG-ML algorithms for survival in spinal metastatic disease in patients managed nonoperatively with radiation.

Study design: Retrospective cohort.

Methods: The performance of the SORG-ML algorithms was assessed by discrimination [receiver operating curves and area under the receiver operating curve (AUC)], calibration (calibration plots), decision curve analysis, and overall performance (Brier score). The primary outcomes were 90-day and 1-year mortality.

Results: Overall, 2074 adult patients underwent radiation for spinal metastatic disease and 29% (n=521) and 59% (n=917) had 90-day and 1-year mortality, respectively. On complete case analysis (n=415), the AUC was 0.76 (95% CI: 0.71-0.80) and 0.78 (95% CI: 0.73-0.83) for 90-day and 1-year mortality with fair calibration and positive net benefit confirmed by the decision curve analysis. With multiple imputation (n=2074), the AUC was 0.85 (95% CI: 0.83-0.87) and 0.87 (95% CI: 0.85-0.89) for 90-day and 1-year mortality with fair calibration and positive net benefit confirmed by the decision curve analysis.

Conclusion: The SORG-ML algorithms for survival in spinal metastatic disease generalize well to patients managed nonoperatively with radiation.

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非手术放疗脊柱转移性疾病患者的生存率：SORG-ML 算法是否相关？

背景数据摘要：SORG-ML脊柱转移性疾病生存率算法是针对接受手术治疗的患者制定的，并对接受手术治疗的患者进行了外部验证：研究设计：研究设计：回顾性队列：通过判别[接收器工作曲线和接收器工作曲线下面积（AUC）]、校准（校准图）、决策曲线分析和总体表现（Brier评分）评估SORG-ML算法的性能。主要结果是 90 天和 1 年死亡率：共有 2074 名成人患者因脊柱转移性疾病接受了放射治疗，90 天和 1 年死亡率分别为 29%（521 人）和 59%（917 人）。通过完整病例分析（n=415），90 天和 1 年死亡率的 AUC 分别为 0.76（95% CI：0.71-0.80）和 0.78（95% CI：0.73-0.83），校准结果尚可，决策曲线分析证实净获益为正。多重归因（n=2074）后，90天和1年死亡率的AUC分别为0.85（95% CI：0.83-0.87）和0.87（95% CI：0.85-0.89），校准结果尚可，决策曲线分析证实净效益为正：结论：SORG-ML 算法对脊柱转移性疾病患者的生存率具有很好的通用性，适用于接受放射治疗的非手术患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.