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Prognostic Factors of Ogihara et al for a Patient with Lung Cancer Metastatic to the Spine

Description

Ogihara et al evaluated factors associated with survival in patients with lung cancer metastatic to the spine (Stage IV). These can help identify patients who may survive long enough to benefit from spinal surgery. The authors are from the University of Tokyo.


 

Types of lung cancer:

(1) small cell

(2) non-small cell

 

Non-Small Cell Lung Cancer

 

Prognostic Factors

Good Prognosis

Poor Prognosis

serum calcium

< 10.5 mg/dL

>= 10.5 mg/dL

serum albumin

>= 3.0 g/dL

< 3.0 g/dL

post-operative ECOG performance

0 to 2

3 or 4

 

where:

• A patient with poor performance status due to dyspnea or general feebleness will probably have a poor post-operative ECOG performance.

• A patient with pain secondary to spinal metastasis would be expected to have a good post-operative performance.

 

Small Cell Lung Cancer

 

Prognostic Factors

Good Prognosis

Poor Prognosis

serum calcium

< 10.5 mg/dL

>= 10.5 mg/dL

serum albumin

>= 3.0 g/dL

< 3.0 g/dL

chemotherapy

yes

no

 

The ideal candidate for spinal surgery will have none of the poor prognostic features. Palliative care becomes more attractive as the number of poor prognostic factors increase.

 

Palliative care may include:

(1) radiation of the spinal metastases

(2) spinal orthosis to stabilize the spine

(3) medications for pain and to control the serum calcium

 


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