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Spine

Prognostic Factors for Patients With SpinalMetastases From Lung Cancer

Satoshi Ogihara, MD, Atsushi Seichi, MD, Takahiro Hozumi, MD, Hiroyuki Oka, MD, Ryuuji Ieki,MD, Kozo Nakamura, MD, Taiji Kondoh, MD Disclosures

Abstract and Introduction

Abstract

Study Design: We conducted a retrospective study to identify prognosticfactors of patients with spinal metastases from lung cancer.

Objective: To provide clinical data with strong association to the prognosisand to propose criteria determining indication of operation for spinal

metastases.

Summary of Background Data: To make a proper selection of patients forwhom surgery is indicated, forecasting short-time survival after spinalmetastases is very important. In the past, there has been no report ofprognostic factors of patients with such metastases from this cancer.

Methods: This study included 114 patients with spinal metastases of lungcancer. Tumors were histologically categorized as non-small cell lung

cancer (NSCLC) in 94 patients and small cell lung cancer (SCLC) in 20patients. We investigated prognostic factors after spinal metastases using

Cox comparative hazard model and a preoperative prognostic scoreproposed by Tokuhashi. We also investigated the patients who underwent operation for spinal metastases from lung cancer in

our hospital.

Results: Multivariate analysis showed that the significant prognostic factors for survival after spinal metastases from NSCLCwere performance status (PS), Ca, Alb. Among SCLC patients, Ca, Alb, and a history of chemotherapy were significant (P <0.05) in univariate analysis. The score of Tokuhashi was not correlative to the survival period. Among the operated patients,

postoperative PS was significant for the period of postoperative survival.

Conclusion: PS, Ca, and Alb in NSCLC and Ca, Alb, and a history of chemotherapy in SCLC are useful for determining anindication of operation for spinal metastases from lung cancer.

Introduction

Lung cancer is the leading cause of cancer-related death in men and women in the world.[1] Lung cancer has been reported tofrequently metastasize to the bone, especially to the spine, the reported incidence being 44% and 26%.[2,3] Clinicians

sometimes encounter patients with spinal metastases from lung cancer. Paralysis due to spinal cord compression decreasesthe activities of daily living (ADL) of patients and forces a surgeon to make a determination about the necessity of surgical

treatment. To decide on the optimal treatment, medical personnel including surgeons must have information on theirprognosis. The prognosis of lung cancer patients with spinal metastases has been considered worse than that of other cancers

with spinal metastases;[4,5] therefore, conservative palliative therapies have been chosen in many cases.

To make a proper selection of patients indicated for surgery, forecasting the individual's short-time survival after theoccurrence of spinal metastases is very important. An expected survival time over 3 to 6 months has been used as a criterionfor choosing surgical treatment,[4] but there have been few reports of prognostic factors of patients with spinal metastases.

We conducted a retrospective study to identify prognostic factors of patients with spinal metastases of lung cancer, and weattempted to provide clinical data with a strong association to the prognosis and to propose criteria for determining indication

of surgery in these cases.

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Spine. 2006;31(14):1585-1590.

Abstract and IntroductionPatients and Methods

ResultsDiscussion

ReferencesSidebar: Key Points

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CommentCommentCommentComment

Spine. 2006;31(14):1585-1590. © 2006 Lippincott Williams & Wilkins

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party relateddirectly or indirectly to the subject of this manuscript.

The manuscript submitted does not contain information about medical device(s)/drug(s).

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