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Erschienen in: Clinical Orthopaedics and Related Research® 2/2013

01.02.2013 | Clinical Research

Is Surgery for Spine Metastasis Reasonable in Patients Older Than 60 Years?

verfasst von: Tangzhao Liang, MD, PhD, Yong Wan, MD, PhD, Xuenong Zou, MD, PhD, Xinsheng Peng, MD, PhD, Shaoyu Liu, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 2/2013

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Abstract

Background

Spinal metastases are common in patients older than 60 years with cancer. Because of the uncertainty of survival and the high incidence of fatal complications, however, chemotherapy and radiotherapy generally have been considered preferable and surgery a treatment of last resort for these patients. Further, the selection criteria indicating surgery and reliable prognostic factors for survival remain controversial.

Questions/purposes

We therefore assessed surgical complications, postoperative function, and risk factors affecting their overall survival.

Methods

We retrospectively reviewed 92 patients 60 years or older (range, 60–81 years) who had surgery for spinal metastases. The surgical complications were recorded and a VAS pain score, Frankel grade, and Karnofsky score were obtained. Statistical analyses were performed to identify factors associated with survival. The minimum followup was 6 months (mean, 22 months; range, 6–78 months).

Results

Surgical complications occurred in 21 patients. Pain levels decreased postoperatively in 90% of patients and neurologic function improved in 78%. The Karnofsky status improved in 58 patients giving an improvement rate of 63%. The overall survival rates at 1 year and 3 years were 61% and 35% with a median of 15 months. Primary tumor type and Tokuhashi score independently predicted survival in patients with spinal metastases.

Conclusion

Our findings suggest surgery for spinal metastasis can achieve pain relief, neurologic improvement, and restoration of general condition but with a high risk of complications. Primary tumor type and Tokuhashi scoring independently predicted survival in patients with spinal metastases after surgery.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadaten
Titel
Is Surgery for Spine Metastasis Reasonable in Patients Older Than 60 Years?
verfasst von
Tangzhao Liang, MD, PhD
Yong Wan, MD, PhD
Xuenong Zou, MD, PhD
Xinsheng Peng, MD, PhD
Shaoyu Liu, MD
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 2/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2699-3

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