Xu Nanfang, Chang Shuai, Liu Xiaoguang, Jiang Liang, Yu Miao, Wu Fengliang, Dang Lei, Zhou Hua, Li Yan, Wang Yongqiang, Liu Xiao, Wu Yunxia, Wei Feng, Liu Zhongjun
Department of Orthopedics, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China.
Front Surg. 2023 Jan 6;9:1011100. doi: 10.3389/fsurg.2022.1011100. eCollection 2022.
To evaluate the survival and medium to long term health-related quality of life (HRQoL) of patients with primary cervical spinal tumors in a cross-sectional study and to identify any significant associations with demographic or clinical characteristics.
Patients diagnosed with primary cervical spinal tumors were retrospectively enrolled and their clinical, radiologic, and follow-up data (specifically the EQ-5D questionnaire) were collected. Univariate and multivariate Cox time-dependent regression analyses were performed to examine the significance of certain variables on overall survival. Univariate and multivariate logistic regression analyses were conducted to identify variables significant for overall HRQoL and each dimension of the EQ-5D.
A total of 341 patients were enrolled in the study with a mean follow-up of 70 months. The diagnosis was benign in 246 cases, malignant in 84, and unconfirmed in 11. The 5-year overall survival rate was 86% and the 10-year overall survival rate was 65%. Multivariate analysis suggested that surgical treatment ( = 0.002, hazard ratio [HR] = 0.431, 95% CI. [0.254, 0.729]), benign and malignant tumors [ < 0.001, HR = 2.788, 95% CI. (1.721, 4.516)], tumor and surrounding normal tissue boundary [ = 0.010, HR = 1.950, 95% CI. (1.171, 3.249)], and spinal instability [ = 0.031, HR = 1.731, 95% CI. (1.051, 2.851)] still had significant effects on survival.
In this cross-sectional study, we evaluated the survival period and medium and long-term health-related quality of life of patients with primary tumors of the cervical spine, and analyzed the significant related factors of tumor clinical characteristics. Surgery, myelopathy, malignancy, spinal pain relieved by lying down or supine position, and tumor infiltration on MRI were significant predictors for overall survival. Enneking stage and age were significant predictors for HRQoL.
在一项横断面研究中评估原发性颈椎肿瘤患者的生存率以及中长期健康相关生活质量（HRQoL），并确定其与人口统计学或临床特征之间的任何显著关联。
回顾性纳入诊断为原发性颈椎肿瘤的患者，并收集其临床、放射学和随访数据（特别是EQ-5D问卷）。进行单因素和多因素Cox时间依赖性回归分析，以检验某些变量对总生存期的显著性。进行单因素和多因素逻辑回归分析，以确定对总体HRQoL和EQ-5D各维度有显著意义的变量。
共341例患者纳入本研究，平均随访70个月。诊断为良性246例，恶性84例，未确诊11例。5年总生存率为86%，10年总生存率为65%。多因素分析表明，手术治疗（=0.002，风险比[HR]=0.431，95%可信区间[CI].[0.254,0.729]）、良性和恶性肿瘤[<0.001，HR=2.788，95%CI.(1.721,4.516)]、肿瘤与周围正常组织边界[=0.010，HR=1.950，95%CI.(1.171,3.249)]以及脊柱不稳定[=0.031，HR=1.731，95%CI.(1.051,2.851)]对生存率仍有显著影响。
在本横断面研究中，我们评估了颈椎原发性肿瘤患者的生存期以及中长期健康相关生活质量，并分析了肿瘤临床特征的显著相关因素。手术、脊髓病、恶性肿瘤、卧位或仰卧位可缓解的脊柱疼痛以及MRI上的肿瘤浸润是总生存期的显著预测因素。Enneking分期和年龄是HRQoL的显著预测因素。
