脊柱转移瘤手术治疗后的预后因素

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-06-01 Epub Date: 2024-05-20 DOI:10.31616/asj.2023.0376
Kazuhiro Murotani, Shunsuke Fujibayashi, Bungo Otsuki, Takayoshi Shimizu, Takashi Sono, Eijiro Onishi, Hiroaki Kimura, Yasuyuki Tamaki, Naoya Tsubouchi, Masato Ota, Ryosuke Tsutsumi, Tatsuya Ishibe, Shuichi Matsuda
{"title":"脊柱转移瘤手术治疗后的预后因素","authors":"Kazuhiro Murotani, Shunsuke Fujibayashi, Bungo Otsuki, Takayoshi Shimizu, Takashi Sono, Eijiro Onishi, Hiroaki Kimura, Yasuyuki Tamaki, Naoya Tsubouchi, Masato Ota, Ryosuke Tsutsumi, Tatsuya Ishibe, Shuichi Matsuda","doi":"10.31616/asj.2023.0376","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A retrospective multicenter case series was conducted.</p><p><strong>Purpose: </strong>This study aimed to investigate survival and prognostic factors after surgery for a metastatic spinal tumor.</p><p><strong>Overview of literature: </strong>Prognostic factors after spinal metastasis surgery remain controversial.</p><p><strong>Methods: </strong>A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model.</p><p><strong>Results: </strong>The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23-10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10-5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72-12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15-0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26-0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14-0.32; p<0.01) were suggested to improve survival.</p><p><strong>Conclusions: </strong>Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222892/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic Factors after Surgical Treatment for Spinal Metastases.\",\"authors\":\"Kazuhiro Murotani, Shunsuke Fujibayashi, Bungo Otsuki, Takayoshi Shimizu, Takashi Sono, Eijiro Onishi, Hiroaki Kimura, Yasuyuki Tamaki, Naoya Tsubouchi, Masato Ota, Ryosuke Tsutsumi, Tatsuya Ishibe, Shuichi Matsuda\",\"doi\":\"10.31616/asj.2023.0376\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A retrospective multicenter case series was conducted.</p><p><strong>Purpose: </strong>This study aimed to investigate survival and prognostic factors after surgery for a metastatic spinal tumor.</p><p><strong>Overview of literature: </strong>Prognostic factors after spinal metastasis surgery remain controversial.</p><p><strong>Methods: </strong>A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model.</p><p><strong>Results: </strong>The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23-10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10-5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72-12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15-0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26-0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14-0.32; p<0.01) were suggested to improve survival.</p><p><strong>Conclusions: </strong>Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.</p>\",\"PeriodicalId\":8555,\"journal\":{\"name\":\"Asian Spine Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222892/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Spine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31616/asj.2023.0376\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Spine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31616/asj.2023.0376","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/20 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

研究设计目的:本研究旨在探讨脊柱转移性肿瘤术后的生存率和预后因素:脊柱转移瘤手术后的预后因素仍存在争议:方法:进行了一项回顾性多中心研究。研究对象包括2010年至2020年期间在日本九家脊柱转诊中心接受脊柱转移手术的345名患者。每位患者的数据均从病历中提取。为了确定预测术后生存预后的因素,我们使用 Cox 比例危险模型进行了单变量分析:平均年龄为 65.9 岁。常见的原发性肿瘤为肺癌(72例)、前列腺癌(61例)和乳腺癌(39例),67.8%(234例)的患者为溶骨性病变。硬膜外脊髓压迫量表评分为2或3分的患者占79.0%(n=271)。弗兰克尔A级瘫痪占1.4%(n=5),73.3%(n=253)根据新的片桐评分被归类为中危或高危。6个月的总生存率为-71.0%,12个月的总生存率为57.4%,24个月的总生存率为43.3%。在单变量分析中,Frankel 分级 A(危险比 [HR],3.59;95% 置信区间 [CI],1.23-10.50;pConclusions:Frankel分级A或新版片桐评分中的中危或高危患者的生存率较低,因此应慎重考虑手术指征。术后应考虑化疗或放疗,以提高生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Prognostic Factors after Surgical Treatment for Spinal Metastases.

Study design: A retrospective multicenter case series was conducted.

Purpose: This study aimed to investigate survival and prognostic factors after surgery for a metastatic spinal tumor.

Overview of literature: Prognostic factors after spinal metastasis surgery remain controversial.

Methods: A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model.

Results: The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23-10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10-5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72-12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15-0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26-0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14-0.32; p<0.01) were suggested to improve survival.

Conclusions: Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
期刊最新文献
A magnetic resonance imaging-based morphometric analysis of bilateral L1-L5 oblique lumbar interbody fusion corridor: feasibility of safe surgical approach and influencing factors. A novel pedicle screw design to maximize screw-bone interface strength using finite element analysis and design of experiment techniques. Factors related to surgical site infection in spinal instrumentation surgery: a retrospective study in Japan. Perioperative complications in patients aged ≥85 years undergoing spinal surgery: a retrospective comparative study of pre-old and old patients in Japan. A novel technique for posterior lumbar interbody fusion to obtain a good local lordosis angle: anterior-release posterior lumbar interbody fusion.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1