Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Sahmyook Medical Center, Seoul, Korea.
Clin Orthop Surg. 2023 Feb;15(1):109-117. doi: 10.4055/cios22115. Epub 2023 Jan 13.
This study aimed to examine trends in postoperative survival and surgical methods over a 25-year period in patients surgically treated for metastatic spinal tumors.
We performed a retrospective study of patients who underwent surgical treatment for metastatic spinal tumors between 1996 and 2020. For trend analysis, the study cohort was divided into three groups according to the year of surgery: 1996-2004, 2005-2012, and 2013-2020. A Kaplan-Meier survival analysis was performed to examine survival, and the log-rank test was used to compare the survival of the top six common cancers among the periods. The surgical methods were grouped and examined as follows: fixation only, palliative decompression and fixation, gross total removal and fixation, and total spondylectomy.
This study included a total of 608 patients. There were 78 patients in 1996-2004, 236 in 2005-2012, and 294 in 2013-2020. Regarding the overall survival trend, the group 2013-2020 had a significantly improved survival as compared to the other two groups ( < 0.001). According to specific cancer sites, significant survival improvement was observed in patients with lung, kidney, and breast cancers ( < 0.001, < 0.001, and = 0.022, respectively). There were no significant changes in the primary sites of the liver, colorectum, or prostate. Regarding surgical methods, the proportion of gross total tumor removal declined, whereas the proportion of palliative decompression and fixation and fixation only procedures increased.
During the past 25 years, significant survival improvement was observed in patients with lung, kidney, and breast cancers. There was no improvement in survival in patients with liver, colorectal, and prostate cancers. In terms of surgical techniques, palliative decompression and fixation only procedures increased, while gross total tumor removal declined.
本研究旨在探讨 25 年间接受转移性脊柱肿瘤手术治疗的患者术后生存和手术方法的变化趋势。
我们对 1996 年至 2020 年间接受手术治疗的转移性脊柱肿瘤患者进行了回顾性研究。为了进行趋势分析，将研究队列按手术年份分为三组：1996-2004 年、2005-2012 年和 2013-2020 年。进行 Kaplan-Meier 生存分析以检查生存情况，并使用对数秩检验比较各时期前六种常见癌症的生存情况。将手术方法分组并进行如下检查：仅固定、姑息性减压和固定、大体全切除和固定以及全脊椎切除术。
本研究共纳入 608 例患者。1996-2004 年 78 例，2005-2012 年 236 例，2013-2020 年 294 例。关于整体生存趋势，2013-2020 组的生存明显优于其他两组（<0.001）。根据特定的癌症部位，肺癌、肾癌和乳腺癌患者的生存显著改善（<0.001、<0.001 和=0.022，分别）。肝癌、结直肠癌和前列腺癌的原发部位无明显变化。关于手术方法，大体全肿瘤切除的比例下降，而姑息性减压和固定以及仅固定的比例增加。
在过去的 25 年中，肺癌、肾癌和乳腺癌患者的生存显著改善。肝癌、结直肠癌和前列腺癌患者的生存无改善。在手术技术方面，姑息性减压和固定仅程序增加，而大体全肿瘤切除减少。
