Overall Survival in Spinal Metastasis Surgery, Single Center Experienced in 5 Years
Keywords:
Spinal Metastasis, Surgery, Revised Tokuhashi score, Survival, Spine surgeryAbstract
Objectives: The researchers aimed to evaluate overall survival after surgery in patients with spinal metastases and to identify prognostic factors influencing survival time.
Materials and Methods: This retrospective study was conducted over a 5-year period at Chulalongkorn Hospital, from January 2017 to January 2022. Data collected included demographic information, primary cancer type, level of metastasis, presence of weakness, Revised Tokuhashi Score (RTS), modified Rankin Scale (mRS) score, and overall survival after spine surgery.
Results: Among 78 patients who underwent spinal surgery, those with an RTS of ≥ 7 had a median survival of 14.20 months and a mean survival of 13.48 months. Significant prognostic factors for survival included RTS (HR 0.7 [95% CI: 0.62–0.81]), mRS at presentation (HR 1.43 [95% CI: 1.1–1.87]), and cancer type, specifically thyroid (HR 0.04 [95% CI: 0–0.43]) and prostate (HR 0.15 [95% CI: 0.04–0.57]). Patients with an mRS score ≥ 4 at presentation had a median survival of less than 6 months.
Conclusions: Patients with an RTS ≥ 7 had a survival rate exceeding 6 months, which is higher than the original Revised Tokuhashi survival estimate. RTS remains a useful tool for patient assessment and surgical decision-making in cases of spinal metastasis.
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