Hirabayashi et al identified risk factors associated with survival after palliative surgery for spinal metastases. These can help separate patients with a relatively long survival from those whose prognosis is poor. The authors are from Shinshu University in Nagano, Japan.
Parameters:
(1) site of primary tumor
(2) ability to ambulate post-operatively
(3) number of months able to walk after surgery
|
Primary Site |
Survival Group |
Median Survival in Months |
|
multiple myeloma (bone marrow) |
long |
44.4 |
|
thyroid |
long |
25.5 |
|
prostate |
long |
20.1 |
|
breast |
intermediate |
18.6 |
|
rectum |
intermediate |
15.2 |
|
liver |
short |
8.7 |
|
kidney |
short |
8.8 |
|
other |
short |
7.0 |
|
pancreas |
short |
5.7 |
|
esophagus |
short |
4.7 |
|
lung |
short |
4.5 |
|
stomach |
short |
2.1 |
from Table 5, page 479
NOTE: The authors separated patients into those with favorable cancers (myeloma, thyroid, prostate) and those with unfavorable (all others). I think breast and rectum are worth separating into an intermediate category.
Patients who were able to ambulate after surgery had a median survival of 14.7 months, while those who were unable to ambulate had a median survival of 3.6 months (Figure 2, page 480).
|
Parameter |
Relative Hazard |
95% CI |
p value |
|
favorable histology (long survival group) |
6.9 |
3.3 – 14.6 |
< 0.0001 |
|
postoperative ambulation |
3.6 |
2.1 – 7.2 |
< 0.0001 |
For patients who were able to ambulate after surgery (Figure 4, page 481):
survival in months =
= (0.976 * (months able to walk after surgery)) + 2.725
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,
