Orthopaedic Oncology Center, Department of Orthopaedics,Changzheng Hospital, Second Military Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China.
J Neurooncol. 2018 Apr;137(2):387-394. doi: 10.1007/s11060-017-2728-x. Epub 2018 Jan 18.
The aim of this study was to provide some useful information concerning clinical characteristics, surgical treatment, potential contributing factor and prognostic factors for patients with gynecological cancer (GC) spinal metastasis. We reviewed 28 patients with GC spinal metastasis in our spine tumor center between July 2008 and July 2015. Surgeries were performed on 22 of them. Univariate and multivariate analyses were conducted to identify potential prognostic factors affecting spinal metastasis-free survival (SMFS) and overall survival. The operative patients responded favorably according to decrease of VAS score and increase of Frankel grade after surgery. The 1- and 2-year survival rates in all patients were 60.7 and 41.0%, respectively. Univariate analysis suggested that age at diagnosis with GC was the potential contributing factor for spinal metastasis, while Frankel grade, ECOG-PS, visceral metastasis and chemotherapy were the potential prognostic factors affecting survival. Multivariate analysis indicated that the independent prognostic factors came from visceral metastasis and chemotherapy. Surgery played an important role in improving patients' quality of life. Patients over 50 years old had a shorter SMFS after diagnosed with GC. Visceral metastasis was an adverse prognostic factor for patients with GC spinal metastasis, while chemotherapy was a favorable one.
本研究旨在提供与妇科癌症(GC)脊柱转移患者的临床特征、手术治疗、潜在影响因素和预后因素相关的有用信息。我们回顾了 2008 年 7 月至 2015 年 7 月期间在我们脊柱肿瘤中心治疗的 28 例 GC 脊柱转移患者,其中 22 例行手术治疗。对所有患者进行了单因素和多因素分析,以确定影响脊柱转移无进展生存(SMFS)和总生存的潜在预后因素。手术患者的 VAS 评分降低,Frankel 分级提高,术后反应良好。所有患者的 1 年和 2 年生存率分别为 60.7%和 41.0%。单因素分析表明,GC 诊断时的年龄是脊柱转移的潜在影响因素,而 Frankel 分级、ECOG-PS、内脏转移和化疗是影响生存的潜在预后因素。多因素分析表明,独立的预后因素来自内脏转移和化疗。手术在提高患者生活质量方面发挥了重要作用。诊断为 GC 后,年龄超过 50 岁的患者 SMFS 较短。内脏转移是 GC 脊柱转移患者的不良预后因素,而化疗是有利因素。