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KMID : 1148120180080010026
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Journal of Advanced Spine Surgery
2018 Volume.8 No. 1 p.26 ~ p.36
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Prognostic Factor Affecting the Survival Time for Patients Undergoing the Surgical Treatment for Spinal Metastases From Non-small Cell Lung Cancer
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Lee Chong-Suh
Park Se-Jun
Chung Sung-Soo
Lee Kyung-Jun
Kim Do-Koon
Lee Ji-Wun
Kim Jong-Hoon
Yum Tae-Hoon
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Abstract
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Purpose: There were few available data regarding the prognosis after the surgical treatment for spinal metastases from non-small cell lung cancer (NSCLC) despite its great frequency. The aim of this study was to investigate the prognostic factors for patients who underwent the surgical treatment for spinal metastases from NSCLC.
Materials and Methods: Eighty-seven patients who underwent surgical treatment for spinal metastases from NSCLC were followed up semi-prospectively. There were 43 patients with metastatic spinal cord compression (MSCC) and 44 patients without MSCC. The prognosis analysis was performed according to 3-categorical variables: patients’, oncologic, and treatments’ factors. Major complications and mortality rate were recorded. The impact of postoperative chemotherapy was evaluated separately.
Results: The overall survival time was median 6.8 months. Postoperative ECOG-PS (0-2 vs. 3, 4) was shown as a significant prognostic factors in both MSCC and non-MSCC groups with HR (hazards ratio) of 2.46 and 2.54, respectively. Major complications developed in 26 patients and 30-day mortality rate was 8.0%. The presence of major complications was also prognostic factor in both groups with HR of 2.55 and 4.47. Earlier surgery within 72 hours showed better prognosis in MSCC group with HR of 2.46. Patients who underwent postoperative chemotherapy survived longer significantly than those who couldn’t with median survival time of 12.0 vs 2.8 months.
Conclusions: Postoperative ECOG-PS and complications were significant prognostic factors in both groups and earlier surgery in MSCC group. The postoperative chemotherapy was another independent prognostic factor affecting the survival time
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KEYWORD
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Spinal metastases, Metastatic spinal cord compression, Non-small cell lung cancer, Surgical treatment, Chemotherapy
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