Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment

Study Design Retrospective study. Purpose The purpose of this study was to see how well the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic Skeletal Oncology Research Group (SORG) algorithm, SORG nomogram, and New England Spinal Metastasis Score (NESMS) pre...

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Main Authors: Van Tri Truong, Fidaa Al-Shakfa, David Roberge, Giuseppina Laura Masucci, Thi Phuoc Yen Tran, Rama Dib, Sung-Joo Yuh, Zhi Wang
Format: Article
Language:English
Published: Korean Spine Society 2023-08-01
Series:Asian Spine Journal
Subjects:
Online Access:http://www.asianspinejournal.org/upload/pdf/asj-2022-0377.pdf
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author Van Tri Truong
Fidaa Al-Shakfa
David Roberge
Giuseppina Laura Masucci
Thi Phuoc Yen Tran
Rama Dib
Sung-Joo Yuh
Zhi Wang
author_facet Van Tri Truong
Fidaa Al-Shakfa
David Roberge
Giuseppina Laura Masucci
Thi Phuoc Yen Tran
Rama Dib
Sung-Joo Yuh
Zhi Wang
author_sort Van Tri Truong
collection DOAJ
description Study Design Retrospective study. Purpose The purpose of this study was to see how well the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic Skeletal Oncology Research Group (SORG) algorithm, SORG nomogram, and New England Spinal Metastasis Score (NESMS) predicted 3-month, 6-month, and 1-year survival of non-surgical lung cancer spinal metastases. Overview of Literature There has been no study assessing the performance of prognostic scores for non-surgical lung cancer spinal metastases. Methods Data analysis was carried out to identify the variables that had a significant impact on survival. For all patients with spinal metastasis from lung cancer who received non-surgical treatment, the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic SORG algorithm, SORG nomogram, and NESMS were calculated. The performance of the scoring systems was assessed by using receiver operating characteristic (ROC) curves at 3 months, 6 months, and 12 months. The predictive accuracy of the scoring systems was quantified using the area under the ROC curve (AUC). Results A total of 127 patients are included in the present study. The median survival of the population study was 5.3 months (95% confidence interval [CI], 3.7–9.6 months). Low hemoglobin was associated with shorter survival (hazard ratio [HR], 1.49; 95% CI, 1.00–2.23; p=0.049), while targeted therapy after spinal metastasis was associated with longer survival (HR, 0.34; 95% CI, 0.21–0.51; p<0.001). In the multivariate analysis, targeted therapy was independently associated with longer survival (HR, 0.3; 95% CI, 0.17–0.5; p<0.001). The AUC of the time-dependent ROC curves for the above prognostic scores revealed all of them performed poorly (AUC <0.7). Conclusions The seven scoring systems investigated are ineffective at predicting survival in patients with spinal metastasis from lung cancer who are treated non-surgically.
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spelling doaj.art-d2925c9e7bc84f2aaaebefc52bac5da82023-08-23T23:49:26ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-08-0117473974910.31616/asj.2022.03771543Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical TreatmentVan Tri Truong0Fidaa Al-Shakfa1David Roberge2Giuseppina Laura Masucci3Thi Phuoc Yen Tran4Rama Dib5Sung-Joo Yuh6Zhi Wang7 Division of Orthopaedics, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Orthopaedics, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Radiation Oncology, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Radiation Oncology, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Research Center, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Orthopaedics, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Neurosurgery, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada Division of Orthopaedics, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montreal, Montreal, QC, CanadaStudy Design Retrospective study. Purpose The purpose of this study was to see how well the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic Skeletal Oncology Research Group (SORG) algorithm, SORG nomogram, and New England Spinal Metastasis Score (NESMS) predicted 3-month, 6-month, and 1-year survival of non-surgical lung cancer spinal metastases. Overview of Literature There has been no study assessing the performance of prognostic scores for non-surgical lung cancer spinal metastases. Methods Data analysis was carried out to identify the variables that had a significant impact on survival. For all patients with spinal metastasis from lung cancer who received non-surgical treatment, the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic SORG algorithm, SORG nomogram, and NESMS were calculated. The performance of the scoring systems was assessed by using receiver operating characteristic (ROC) curves at 3 months, 6 months, and 12 months. The predictive accuracy of the scoring systems was quantified using the area under the ROC curve (AUC). Results A total of 127 patients are included in the present study. The median survival of the population study was 5.3 months (95% confidence interval [CI], 3.7–9.6 months). Low hemoglobin was associated with shorter survival (hazard ratio [HR], 1.49; 95% CI, 1.00–2.23; p=0.049), while targeted therapy after spinal metastasis was associated with longer survival (HR, 0.34; 95% CI, 0.21–0.51; p<0.001). In the multivariate analysis, targeted therapy was independently associated with longer survival (HR, 0.3; 95% CI, 0.17–0.5; p<0.001). The AUC of the time-dependent ROC curves for the above prognostic scores revealed all of them performed poorly (AUC <0.7). Conclusions The seven scoring systems investigated are ineffective at predicting survival in patients with spinal metastasis from lung cancer who are treated non-surgically.http://www.asianspinejournal.org/upload/pdf/asj-2022-0377.pdfspinal neoplasmsprognosislung neoplasmsarea under curveadenocarcinoma
spellingShingle Van Tri Truong
Fidaa Al-Shakfa
David Roberge
Giuseppina Laura Masucci
Thi Phuoc Yen Tran
Rama Dib
Sung-Joo Yuh
Zhi Wang
Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
Asian Spine Journal
spinal neoplasms
prognosis
lung neoplasms
area under curve
adenocarcinoma
title Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
title_full Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
title_fullStr Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
title_full_unstemmed Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
title_short Assessing the Performance of Prognostic Scores in Patients with Spinal Metastases from Lung Cancer Undergoing Non-surgical Treatment
title_sort assessing the performance of prognostic scores in patients with spinal metastases from lung cancer undergoing non surgical treatment
topic spinal neoplasms
prognosis
lung neoplasms
area under curve
adenocarcinoma
url http://www.asianspinejournal.org/upload/pdf/asj-2022-0377.pdf
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