Background: Spinal metastases are a significant cause of morbidity in patients with advanced cancer, and management often requires surgical intervention. Although prior studies have identified factors that influence outcomes with surgery, the ability of these factors to predict outcomes remains unclear in the era of contemporary therapies, and there is a need to better identify patients who are likely to benefit from surgery. Methods: We performed a single-center, retrospective analysis to evaluate risk factors for poor outcomes in patients with spinal metastases treated with surgery. The primary outcome was mortality at 180 days. Results: A total of 128 patients were identified. Age ≥ 65 years at surgery (p= 0.0316), presence of extraspinal metastases (p= 0.0110), and ECOG performance scores >1 (p= 0.0397) were associated with mortality at 180 days on multivariate analysis. These factors and BMI ≤ 30 mg/kg2(p= 0.0008) were also associated with worse overall survival. Conclusions: Age > 65, extraspinal metastases, and performance status scores >1 are factors associated with mortality at 180 days in patients with spinal metastases treated with surgery. Patients with these factors and BMI ≤ 30 mg/kg2had worse overall survival. Our results support multidisciplinary discussions regarding the benefits and risks associated with surgery in patients with these risk factors.
背景：脊柱转移是晚期癌症患者发病的重要原因，其治疗通常需要手术干预。尽管既往研究已识别出影响手术结果的因素，但在当代治疗时代，这些因素预测结果的能力仍不明确，因此有必要更好地识别可能从手术中获益的患者。方法：我们进行了一项单中心回顾性分析，以评估接受手术治疗的脊柱转移患者不良结局的风险因素。主要结局指标为180天死亡率。结果：共纳入128例患者。多变量分析显示，手术时年龄≥65岁（p=0.0316）、存在脊柱外转移（p=0.0110）以及ECOG体能状态评分>1（p=0.0397）与180天死亡率相关。这些因素及BMI≤30 mg/kg²（p=0.0008）也与较差的总生存期相关。结论：年龄>65岁、脊柱外转移和体能状态评分>1是接受手术治疗的脊柱转移患者180天死亡率的关联因素。具有这些特征且BMI≤30 mg/kg²的患者总生存期更差。我们的研究结果支持对具有这些风险因素的患者进行多学科讨论，以权衡手术相关的获益与风险。
Outcomes in Patients with Spinal Metastases Managed with Surgical Intervention
肿瘤(癌症)患者之家