J Korean Neurosurg Soc.  2011 Sep;50(3):216-223. 10.3340/jkns.2011.50.3.216.

Postoperative Survival and Ambulatory Outcome in Metastatic Spinal Tumors : Prognostic Factor Analysis

• Moon KY
• Chung CK
• Jahng TA
• Kim HJ
• Kim CH

• KMID: 1963612
• DOI: http://doi.org/10.3340/jkns.2011.50.3.216

Abstract

OBJECTIVE
The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute.
METHODS
We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated.
RESULTS
The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001).
CONCLUSION
Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

Keyword

Prognosis; Spinal metastasis; Surgery; Survival; Ambulatory outcome

MeSH Terms

Diagnosis
Factor Analysis, Statistical*
Gait
Humans
Medical Records
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Retrospective Studies
Spinal Cord Compression
Survival Rate