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Spinal metastases outcome

Despite advances in therapies using radiation oncology and spinal oncological surgery, there is a subgroup of patients with spinal metastases who suffer from progressive or recurrent epidural disease and remain at risk for neurological compromise.

Data from the largest prospective surgical series of patients with symptomatic spinal metastases revealed that tumor type, the number of spinal metastases, and the presence of visceral metastases are the most useful predictors of survival and that quality of life is best predicted by preoperative Karnofsky Performance Score, Frankel, and EQ-5D scores. The Karnofsky score predicts quality of life and survival and is easy to determine at the bedside, unlike the EQ-5D index. Karnofsky score, tumor type, and spinal and visceral metastases should be considered the 4 most important prognostic variables that influence patient management 1).

Primary tumor type, presence of visceral metastases and performance status are significant predictors for survival after surgery for symptomatic SEM and should be evaluated before deciding on the extent of treatment. More accurate prediction models are needed to select the best treatment option for the individual patient 2).

Choi D, Fox Z, Albert T, Arts M, Balabaud L, Bunger C, Buchowski JM, Coppes MH, Depreitere B, Fehlings MG, Harrop J, Kawahara N, Martin-Benlloch JA, Massicotte EM, Mazel C, Oner FC, Peul W, Quraishi N, Tokuhashi Y, Tomita K, Verlaan JJ, Wang M, Crockard HA. Prediction of Quality of Life and Survival After Surgery for Symptomatic Spinal Metastases: A Multicenter Cohort Study to Determine Suitability for Surgical Treatment. Neurosurgery. 2015 Nov;77(5):698-708. doi: 10.1227/NEU.0000000000000907. PubMed PMID: 26204361.
Bollen L, de Ruiter GC, Pondaag W, Arts MP, Fiocco M, Hazen TJ, Peul WC, Dijkstra PD. Risk factors for survival of 106 surgically treated patients with symptomatic spinal epidural metastases. Eur Spine J. 2013 Jun;22(6):1408-16. doi: 10.1007/s00586-013-2726-4. Epub 2013 Mar 2. PubMed PMID: 23455954; PubMed Central PMCID: PMC3676552.
spinal_metastases_outcome.txt · Last modified: 2019/09/11 16:13 by administrador