Analysis on Surgical Efficacy and Prognostic Factors for Lung Cancer with Spinal Metastasis
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0615
- VernacularTitle:肺癌脊柱转移瘤的外科治疗疗效及预后因素分析
- Author:
Yu-xi LI
1
;
Shi-xin LU
1
;
Yu-wei LIANG
1
;
Ming LI
1
;
Zi-ying CHENG
1
;
Jun-shen HUANG
1
;
Jia-jun HUANG
1
;
Lin HUANG
1
Author Information
1. Department of Orthopedics， Sun Yat-sen Memorial Hospital， Sun Yat-sen University， Guangzhou 510120， China
- Publication Type:Journal Article
- Keywords:
lung cancer;
spinal metastasis;
surgical procedures;
prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):923-930
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the effect of surgery and prognostic factors on survival in patients with spinal metastasis from lung cancer. MethodsThe clinical and follow-up data of 156 patients with spinal metastasis from lung cancer treated in Sun Yat-sen Memorial Hospital， Sun Yat-sen University from March 2013 to May 2020 were retrospectively analyzed. A total of 36 patients were selected according to the inclusion and exclusion criteria， and were divided into surgical group （n=26） and conservative group （n=10） according to different treatment methods. Visual analog scale score， Karnofsky performance score and Frankel classification were used to evaluate the pain， functional status and spinal cord function of patients before and after treatment. In the end of the study， we drew the Kaplan-Meier survival curve and used Cox proportional hazard model to analyze the factors affecting the prognosis. ResultsThe baseline characteristic of patients in the two groups was similar. In the surgical group， the VAS score of patients decreased from 8.00 （3.00~9.00） to 2.00 （0.75~2.00） after operation. Meanwhile the KPS score of patients increased from 50.00 （40.00~60.00） to 60.00 （50.00~70.00）. And the Frankel classification of patients in surgical group was also improved after operation. The above difference was statistically significant （P＜0.05）. However， there were no statistically differences in VAS scores， KPS scores and Frankel classification before and after treatment in patients of the conservative group. The median survival time of 36 patients was 22.0 months，95%CI （6.3，37.7 ） months， with 1-year survival rate 68.7%， 2-year survival rate 48.0% and 3-year survival rate 33.6%. The results of univariate survival analysis showed gender， smoking history， pathological type， radiotherapy or chemotherapy， and targeted therapy have a significant impact on patients’ survival. The results of multivariate COX proportional hazard model survival analysis suggested radiotherapy or chemotherapy and targeted therapy were independent factors affecting the prognosis. ConclusionsSurgical treatment of spinal metastasis from lung cancer could effectively relieve pain， improve quality of life and improve neurological function. Radiotherapy or chemotherapy and targeted therapy are important factors affecting the survival time of patients with spinal metastasis from lung cancer.
