Quality of life and functional outcomes after surgery for spinal metastases: Results of a cohort study.
Adult
Age Factors
Aged
Aged, 80 and over
Body Mass Index
Disability Evaluation
Female
Humans
Length of Stay
Lumbar Vertebrae
/ surgery
Male
Middle Aged
Physical Functional Performance
Postoperative Complications
/ epidemiology
Prospective Studies
Quality of Life
Sex Factors
Spinal Neoplasms
/ secondary
Core Outcome Measures Index
Spinal metastases
functional outcome
metastatic spine surgery
quality of life
spine
Journal
Technology and health care : official journal of the European Society for Engineering and Medicine
ISSN: 1878-7401
Titre abrégé: Technol Health Care
Pays: Netherlands
ID NLM: 9314590
Informations de publication
Date de publication:
2020
2020
Historique:
pubmed:
9
10
2019
medline:
17
3
2021
entrez:
10
10
2019
Statut:
ppublish
Résumé
Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours. This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort. A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6 weeks postoperatively, and 3, 6, and 12 months postoperatively. Ninety-two patients (mean age, 62.7 ± 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n= 18; 19.6%), lung cancer (n= 16; 17.4%), prostate cancer (n= 14; 15.2%), and breast cancer (n= 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6-7.6) to 3 months (mean, 5.5; 95% CI, 4.8-6.2; p= 0.01) and 12 months (mean, 4.6; 95% CI, 3.7-5.5; p= 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5-57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1-49.6; p= 0.03), 3 months (mean, 37.0; 95% CI, 31.0-42.9) 6 months mean, 40.5; 95% CI, 34.2-46.8; p= 0.01), and 12 months (mean, 31.9; 95% CI, 24.8-39.1; p= 0.005) postoperatively. Improvements in the COMI at 6 weeks (p= 0.05), and 6 months (p= 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38-0.59; p= 0.002), 3 months (mean, 0.50; 95% CI, 0.38-0.61; p= 0.009), and 12 months (mean, 0.61; 95% CI, 0.51-0.71; p= 0.001) postoperatively. After 6 months, the difference was not significant (p= 0.08). Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.
Sections du résumé
BACKGROUND
BACKGROUND
Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours.
OBJECTIVE
OBJECTIVE
This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort.
METHODS
METHODS
A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6 weeks postoperatively, and 3, 6, and 12 months postoperatively.
RESULTS
RESULTS
Ninety-two patients (mean age, 62.7 ± 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n= 18; 19.6%), lung cancer (n= 16; 17.4%), prostate cancer (n= 14; 15.2%), and breast cancer (n= 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6-7.6) to 3 months (mean, 5.5; 95% CI, 4.8-6.2; p= 0.01) and 12 months (mean, 4.6; 95% CI, 3.7-5.5; p= 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5-57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1-49.6; p= 0.03), 3 months (mean, 37.0; 95% CI, 31.0-42.9) 6 months mean, 40.5; 95% CI, 34.2-46.8; p= 0.01), and 12 months (mean, 31.9; 95% CI, 24.8-39.1; p= 0.005) postoperatively. Improvements in the COMI at 6 weeks (p= 0.05), and 6 months (p= 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38-0.59; p= 0.002), 3 months (mean, 0.50; 95% CI, 0.38-0.61; p= 0.009), and 12 months (mean, 0.61; 95% CI, 0.51-0.71; p= 0.001) postoperatively. After 6 months, the difference was not significant (p= 0.08).
CONCLUSION
CONCLUSIONS
Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.
Identifiants
pubmed: 31594268
pii: THC191727
doi: 10.3233/THC-191727
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM