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Spine
Prognostic Factors for Patients With Spinal
Metastases From Lung Cancer
Satoshi Ogihara, MD, Atsushi Seichi, MD, Takahiro Hozumi, MD, Hiroyuki Oka, MD, Ryuuji Ieki,
MD, Kozo Nakamura, MD, Taiji Kondoh, MD Disclosures
Abstract and Introduction
Abstract
Study Design: We conducted a retrospective study to identify prognostic
factors of patients with spinal metastases from lung cancer.
Objective: To provide clinical data with strong association to the prognosis
and to propose criteria determining indication of operation for spinal
metastases.
Summary of Background Data: To make a proper selection of patients for
whom surgery is indicated, forecasting short-time survival after spinal
metastases is very important. In the past, there has been no report of
prognostic factors of patients with such metastases from this cancer.
Methods: This study included 114 patients with spinal metastases of lung
cancer. Tumors were histologically categorized as non-small cell lung
cancer (NSCLC) in 94 patients and small cell lung cancer (SCLC) in 20
patients. We investigated prognostic factors after spinal metastases using
Cox comparative hazard model and a preoperative prognostic score
proposed by Tokuhashi. We also investigated the patients who underwent operation for spinal metastases from lung cancer in
our hospital.
Results: Multivariate analysis showed that the signicant prognostic factors for survival after spinal metastases from NSCLC
were performance status (PS), Ca, Alb. Among SCLC patients, Ca, Alb, and a history of chemotherapy were signicant (P <
0.05) in univariate analysis. The score of Tokuhashi was not correlative to the survival period. Among the operated patients,
postoperative PS was signicant for the period of postoperative survival.
Conclusion: PS, Ca, and Alb in NSCLC and Ca, Alb, and a history of chemotherapy in SCLC are useful for determining an
indication of operation for spinal metastases from lung cancer.
Introduction
Lung cancer is the leading cause of cancer-related death in men and women in the world.
[1]
Lung cancer has been reported to
frequently metastasize to the bone, especially to the spine, the reported incidence being 44% and 26%.
[2,3]
Clinicians
sometimes encounter patients with spinal metastases from lung cancer. Paralysis due to spinal cord compression decreases
the activities of daily living (ADL) of patients and forces a surgeon to make a determination about the necessity of surgical
treatment. To decide on the optimal treatment, medical personnel including surgeons must have information on their
prognosis. The prognosis of lung cancer patients with spinal metastases has been considered worse than that of other cancers
with spinal metastases;
[4,5]
therefore, conservative palliative therapies have been chosen in many cases.
To make a proper selection of patients indicated for surgery, forecasting the individual's short-time survival after the
occurrence of spinal metastases is very important. An expected survival time over 3 to 6 months has been used as a criterion
for choosing surgical treatment,
[4]
but there have been few reports of prognostic factors of patients with spinal metastases.
We conducted a retrospective study to identify prognostic factors of patients with spinal metastases of lung cancer, and we
attempted to provide clinical data with a strong association to the prognosis and to propose criteria for determining indication
of surgery in these cases.
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Spine. 2006;31(14):1585-1590.
Abstract and Introduction
Patients and Methods
Results
Discussion
References
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Comment Comment Comment Comment
Spine. 2006;31(14):1585-1590. 2006 Lippincott Williams & Wilkins
No funds were received in support of this work. No benets in any form have been or will be received from a commercial party related
directly or indirectly to the subject of this manuscript.
The manuscript submitted does not contain information about medical device(s)/drug(s).
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