Metastatic Spine Disease: Should Patients With Short Life Expectancy Be Denied Surgical Care? An International Retrospective Cohort Study.
Health-related quality of life
Life expectancy
Metastatic spine disease
Surgical care
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 08 2020
01 08 2020
Historique:
received:
13
05
2019
accepted:
28
08
2019
pubmed:
7
11
2019
medline:
5
1
2021
entrez:
7
11
2019
Statut:
ppublish
Résumé
Despite our inability to accurately predict survival in many cancer patients, a life expectancy of at least 3 mo is historically necessary to be considered for surgical treatment of spinal metastases. To compare health-related quality of life (HRQOL) in patients surviving <3 mo after surgical treatment to patients surviving >3 mo to assess the validity of this inclusion criteria. Patients who underwent surgery for spinal metastases between August 2013 and May 2017 were retrospectively identified from an international cohort study. HRQOL was evaluated using generic and disease-specific outcome tools at baseline and at 6 and 12 wk postsurgery. The primary outcome was the HRQOL at 6 wk post-treatment measured by the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ). A total of 253 patients were included: 40 patients died within the first 3 mo after surgery and 213 patients survived more than 3 mo. Patients surviving <3 mo after surgery presented with lower baseline performance status. Adjusted analyses for baseline performance status did not reveal a significant difference in HRQOL between both groups at 6 wk post-treatment. No significant difference in patient satisfaction at 6 wk with regard to their treatment could be detected between both groups. When controlled for baseline performance status, quality of life 6 wk after surgery for spinal metastasis is independent of survival. To optimize improvement in HRQOL for this patient population, baseline performance status should take priority over expected survival in the surgical decision-making process.
Sections du résumé
BACKGROUND
Despite our inability to accurately predict survival in many cancer patients, a life expectancy of at least 3 mo is historically necessary to be considered for surgical treatment of spinal metastases.
OBJECTIVE
To compare health-related quality of life (HRQOL) in patients surviving <3 mo after surgical treatment to patients surviving >3 mo to assess the validity of this inclusion criteria.
METHODS
Patients who underwent surgery for spinal metastases between August 2013 and May 2017 were retrospectively identified from an international cohort study. HRQOL was evaluated using generic and disease-specific outcome tools at baseline and at 6 and 12 wk postsurgery. The primary outcome was the HRQOL at 6 wk post-treatment measured by the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ).
RESULTS
A total of 253 patients were included: 40 patients died within the first 3 mo after surgery and 213 patients survived more than 3 mo. Patients surviving <3 mo after surgery presented with lower baseline performance status. Adjusted analyses for baseline performance status did not reveal a significant difference in HRQOL between both groups at 6 wk post-treatment. No significant difference in patient satisfaction at 6 wk with regard to their treatment could be detected between both groups.
CONCLUSION
When controlled for baseline performance status, quality of life 6 wk after surgery for spinal metastasis is independent of survival. To optimize improvement in HRQOL for this patient population, baseline performance status should take priority over expected survival in the surgical decision-making process.
Identifiants
pubmed: 31690935
pii: 5613663
doi: 10.1093/neuros/nyz472
pmc: PMC7360875
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-311Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© Congress of Neurological Surgeons 2019.
Références
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009
Spine (Phila Pa 1976). 2012 Apr 1;37(7):573-82
pubmed: 21796024
BMC Cancer. 2015 May 05;15:354
pubmed: 25939658
Lancet Oncol. 2004 Sep;5(9):530
pubmed: 15337481
J Cancer Res Clin Oncol. 2014 Dec;140(12):2059-64
pubmed: 25035249
Spine (Phila Pa 1976). 2011 May 15;36(11):910-7
pubmed: 21037529
Spine (Phila Pa 1976). 2005 Oct 1;30(19):2186-91
pubmed: 16205345
J Neurosurg Spine. 2010 Jul;13(1):87-93
pubmed: 20594023
J Clin Oncol. 2016 Sep 1;34(25):3054-61
pubmed: 27400936
J Clin Oncol. 2016 Jan 20;34(3):268-76
pubmed: 26598751
Spine J. 2017 Jul;17(7):953-961
pubmed: 28242336
World Neurosurg. 2018 Jan;109:e389-e397
pubmed: 28987846
Spine (Phila Pa 1976). 2001 Feb 1;26(3):298-306
pubmed: 11224867
Lancet Oncol. 2004 Sep;5(9):568-74
pubmed: 15337487
Eur Spine J. 2010 Feb;19(2):215-22
pubmed: 20039084
J Clin Neurosci. 2016 Dec;34:15-22
pubmed: 27634496
Int J Radiat Oncol Biol Phys. 2006 Nov 15;66(4):1212-8
pubmed: 17145536
Lancet. 2005 Aug 20-26;366(9486):643-8
pubmed: 16112300
Spine (Phila Pa 1976). 2013 Jul 15;38(16):1362-7
pubmed: 23574811
Spine (Phila Pa 1976). 2016 Oct 15;41 Suppl 20:S218-S223
pubmed: 27488299
J Neurosurg Spine. 2013 Mar;18(3):207-14
pubmed: 23339593
Orthop Surg. 2016 Aug;8(3):309-15
pubmed: 27627713
Spine (Phila Pa 1976). 2018 Dec 1;43(23):1678-1684
pubmed: 30422958
Spine (Phila Pa 1976). 2014 Oct 15;39(22 Suppl 1):S99-S105
pubmed: 25077913
J Neurosurg Spine. 2017 Mar;26(3):299-306
pubmed: 27834628
Cancer. 2018 Apr 15;124(8):1828-1838
pubmed: 29409108