Validation of the prognostic index for spine metastasis (PRISM) for stratifying survival in patients treated with spinal stereotactic body radiation
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View abstract on PubMed
Summary
This summary is machine-generated.The Prognostic Index for Spinal Metastasis (PRISM) score effectively stratifies patients undergoing spine stereotactic radiosurgery (SSRS) for spinal metastases. Validation across diverse patient cohorts confirms its generalizability in predicting overall survival (OS).
Area Of Science
- Oncology
- Radiotherapy
- Biostatistics
Background
- The Prognostic Index for Spinal Metastasis (PRISM) is a scoring system developed to stratify patients with spinal metastases undergoing spine stereotactic radiosurgery (SSRS).
- Initial validation was based on data from a single institution, necessitating further evaluation of its generalizability.
Purpose Of The Study
- To validate the generalizability of the PRISM score using a large, external dataset from a different high-volume institution.
- To assess the PRISM score's ability to stratify patients by overall survival (OS) in an independent cohort.
Main Methods
- A retrospective analysis of 879 patients who received SSRS between 2007 and 2019 was conducted, including 424 from Mayo Clinic and 455 from MD Anderson Cancer Center (MDACC).
- Patients were stratified using PRISM criteria, and overall survival (OS) was compared between groups using Kaplan-Meier estimations and univariate Cox proportional analyses.
- Model calibration and concordance indices (C-indices) were calculated to evaluate the scoring system's performance in each cohort.
Main Results
- Despite significant differences in patient and tumor characteristics between the Mayo Clinic and MDACC cohorts (P < 0.001), the PRISM score demonstrated robust separation of prognostic groups.
- Median OS varied between cohorts (30.3 months for Mayo, 22.1 months for MDACC), but Kaplan-Meier curves showed clear distinctions between PRISM groups within each cohort.
- Concordance indices (C-indices) for the stratified scores were high in both cohorts (0.66 for Mayo, 0.68 for MDACC), indicating good predictive accuracy.
Conclusions
- The PRISM score is robustly validated by a large, external cohort, demonstrating its generalizability in stratifying overall survival for patients treated with SSRS.
- Despite significant inter-cohort heterogeneity, the PRISM score maintains its predictive performance.
- The PRISM scoring system can aid in guiding treatment selection for patients with spinal metastases.
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