Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival
Prediction of prognosis is a key factor in therapeutic decision making due to recent the development of therapeutic options for spinal metastases. The aim of the study was to examine predictive scoring systems and identify prognostic factors for 6–month mortality after palliative surgery. The partic...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/16/3868 |
| _version_ | 1797446615349329920 |
|---|---|
| author | Hideaki Nakajima Shuji Watanabe Kazuya Honjoh Yuya Izubuchi Yumiko Watanabe Takaaki Tanaka Akihiko Matsumine |
| author_facet | Hideaki Nakajima Shuji Watanabe Kazuya Honjoh Yuya Izubuchi Yumiko Watanabe Takaaki Tanaka Akihiko Matsumine |
| author_sort | Hideaki Nakajima |
| collection | DOAJ |
| description | Prediction of prognosis is a key factor in therapeutic decision making due to recent the development of therapeutic options for spinal metastases. The aim of the study was to examine predictive scoring systems and identify prognostic factors for 6–month mortality after palliative surgery. The participants were 75 patients with spinal metastases who underwent palliative surgery and had a minimum follow–up period of 1 year. Associations of actual survival with categories based on the revised Tokuhashi score and new Katagiri score were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors for 6–month mortality after palliative surgery. The median actual survival period was longer than those predicted using the scoring systems. However, 21.3% of patients died of cancers within 6 months after surgery. A higher CRP/albumin ratio (odds ratio: 0.39; cut–off 0.409) and absence of postoperative adjuvant therapy (odds ratio: 7.15) were independent risk factors for 6–month mortality. There was no association of mortality with primary site, severity of sarcopenia, or other biomarkers. These results suggest that careful consideration is needed to determine whether palliative surgery is the best option for patients with a high preoperative CRP/albumin ratio and/or absence of postoperative adjuvant therapy, regardless of predictions made from scoring systems. |
| first_indexed | 2024-03-09T13:43:09Z |
| format | Article |
| id | doaj.art-4ce1a9b0e18a4acf97f0d017d7b9fe9c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T13:43:09Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4ce1a9b0e18a4acf97f0d017d7b9fe9c2023-11-30T21:03:42ZengMDPI AGCancers2072-66942022-08-011416386810.3390/cancers14163868Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual SurvivalHideaki Nakajima0Shuji Watanabe1Kazuya Honjoh2Yuya Izubuchi3Yumiko Watanabe4Takaaki Tanaka5Akihiko Matsumine6Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, JapanPrediction of prognosis is a key factor in therapeutic decision making due to recent the development of therapeutic options for spinal metastases. The aim of the study was to examine predictive scoring systems and identify prognostic factors for 6–month mortality after palliative surgery. The participants were 75 patients with spinal metastases who underwent palliative surgery and had a minimum follow–up period of 1 year. Associations of actual survival with categories based on the revised Tokuhashi score and new Katagiri score were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors for 6–month mortality after palliative surgery. The median actual survival period was longer than those predicted using the scoring systems. However, 21.3% of patients died of cancers within 6 months after surgery. A higher CRP/albumin ratio (odds ratio: 0.39; cut–off 0.409) and absence of postoperative adjuvant therapy (odds ratio: 7.15) were independent risk factors for 6–month mortality. There was no association of mortality with primary site, severity of sarcopenia, or other biomarkers. These results suggest that careful consideration is needed to determine whether palliative surgery is the best option for patients with a high preoperative CRP/albumin ratio and/or absence of postoperative adjuvant therapy, regardless of predictions made from scoring systems.https://www.mdpi.com/2072-6694/14/16/3868spinal metastasispalliative surgeryprognostic factorsrevised Tokuhashi scorenew Katagiri scoreCRP/albumin ratio |
| spellingShingle | Hideaki Nakajima Shuji Watanabe Kazuya Honjoh Yuya Izubuchi Yumiko Watanabe Takaaki Tanaka Akihiko Matsumine Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival Cancers spinal metastasis palliative surgery prognostic factors revised Tokuhashi score new Katagiri score CRP/albumin ratio |
| title | Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival |
| title_full | Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival |
| title_fullStr | Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival |
| title_full_unstemmed | Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival |
| title_short | Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival |
| title_sort | prognosis after palliative surgery for patients with spinal metastasis comparison of predicted and actual survival |
| topic | spinal metastasis palliative surgery prognostic factors revised Tokuhashi score new Katagiri score CRP/albumin ratio |
| url | https://www.mdpi.com/2072-6694/14/16/3868 |
| work_keys_str_mv | AT hideakinakajima prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT shujiwatanabe prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT kazuyahonjoh prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT yuyaizubuchi prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT yumikowatanabe prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT takaakitanaka prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival AT akihikomatsumine prognosisafterpalliativesurgeryforpatientswithspinalmetastasiscomparisonofpredictedandactualsurvival |