[Descriptive analytical study of patient survival with vertebral metastases in a rheumatological setting in Togo]

Metastases, especially bone metastases, are common during the progression of certain cancers and most often threaten the patient's life or sometimes their functional prognosis (spinal cord compression). The objective of this study is to evaluate the survival of patients with vertebral metastases in Togo. We conducted a retrospective, cross-sectional, descriptive, and analytical study over 5 years, from 2016 to 2020, in the Rheumatology Departments of Kara University Hospital, Sylvanus Olympio, and Bè Hospital in Togo, including all patients diagnosed with bone and/or visceral metastases from a primary tumor. The Tokuhashi score was used. Multivariate regression analysis was performed to identify associated factors. We collected data on 82 patients, predominantly male (53 men, 64.63%), with a mean age of 65 years for the men. Prostate cancer was found in 46 patients (56.09%), followed by breast cancer in 12 patients (14.63%). Factors statistically associated with poor prognosis were the presence of a radiographic lytic image (ORa: 3.87; 95% CI: 1.66 - 4.85) and a mixed image (ORa: 2.58; 95% CI: 1.38 - 4.74) with p<0.004 and p<0.001, respectively. In our study, 63.3% of patients with a poor prognosis survived less than 6 months (ORa: 4.99; 95% CI: 7.26 - 40.0) with p = 0.001. A multivariate analysis between the most frequent tumors and survival according to the Tokuhashi score found that prostate cancer (n = 46) was associated with a median actual survival of 17.9 months (OR: 0.23; 95% CI: 0.11-0.48), versus a Tokuhashi score predicted survival of 9.87 months. Breast cancer (n = 12) showed an actual survival of 9.87 months (OR: 0.48; 95% CI: 0.21-1.14) with a predicted survival of 8.92 months. Bone metastases are associated with significant morbidity and patient survival. The presence of a lytic radiographic image and a mixed image are statistically significant factors of poor prognosis. Prostate cancer and breast cancer are the most frequent cancers and are statistically associated with patient survival according to the Tokuhashi score, with an actual survival of 17.9 months against a Tokuhashi score-predicted survival of 9.87 months, and breast cancer with an actual survival of 9.87 months against a predicted survival of 8.82.