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Prognostic factors for patients with spinal metastases from lung cancer
Satoshi Ogihara1, Atsushi Seichi, Takahiro Hozumi
1Department of Orthopaedic Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Study Design:
We conducted a retrospective study to identify prognostic factors of patients with spinal metastases from lung cancer.
Objective:
To provide clinical data with strong association to the prognosis and to propose criteria determining indication of operation for spinal metastases.
Summary Of Background Data:
To make a proper selection of patients for whom surgery is indicated, forecasting short-time survival after spinal metastases is very important. In the past, there has been no report of prognostic factors of patients with such metastases from this cancer.
Methods:
This study included 114 patients with spinal metastases of lung cancer. Tumors were histologically categorized as non-small cell lung cancer (NSCLC) in 94 patients and small cell lung cancer (SCLC) in 20 patients. We investigated prognostic factors after spinal metastases using Cox comparative hazard model and a preoperative prognostic score proposed by Tokuhashi. We also investigated the patients who underwent operation for spinal metastases from lung cancer in our hospital.
Results:
Multivariate analysis showed that the significant prognostic factors for survival after spinal metastases from NSCLC were performance status (PS), Ca, Alb. Among SCLC patients, Ca, Alb, and a history of chemotherapy were significant (P < 0.05) in univariate analysis. The score of Tokuhashi was not correlative to the survival period. Among the operated patients, postoperative PS was significant for the period of postoperative survival.
Conclusion:
PS, Ca, and Alb in NSCLC and Ca, Alb, and a history of chemotherapy in SCLC are useful for determining an indication of operation for spinal metastases from lung cancer.