Truong Van Tri, Al-Shakfa Fidaa, Roberge David, Masucci Giuseppina Laura, Tran Thi Phuoc Yen, Dib Rama, Yuh Sung-Joo, Wang Zhi
Division of Orthopaedics, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montreal, QC, Canada.
Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam.
Asian Spine J. 2023 Aug;17(4):739-749. doi: 10.31616/asj.2022.0377. Epub 2023 Jul 6.
Retrospective study.
The purpose of this study was to see how well the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic Skeletal Oncology Research Group (SORG) algorithm, SORG nomogram, and New England Spinal Metastasis Score (NESMS) predicted 3-month, 6-month, and 1-year survival of non-surgical lung cancer spinal metastases.
There has been no study assessing the performance of prognostic scores for non-surgical lung cancer spinal metastases.
Data analysis was carried out to identify the variables that had a significant impact on survival. For all patients with spinal metastasis from lung cancer who received non-surgical treatment, the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic SORG algorithm, SORG nomogram, and NESMS were calculated. The performance of the scoring systems was assessed by using receiver operating characteristic (ROC) curves at 3 months, 6 months, and 12 months. The predictive accuracy of the scoring systems was quantified using the area under the ROC curve (AUC).
A total of 127 patients are included in the present study. The median survival of the population study was 5.3 months (95% confidence interval [CI], 3.7-9.6 months). Low hemoglobin was associated with shorter survival (hazard ratio [HR], 1.49; 95% CI, 1.00-2.23; p =0.049), while targeted therapy after spinal metastasis was associated with longer survival (HR, 0.34; 95% CI, 0.21-0.51; p <0.001). In the multivariate analysis, targeted therapy was independently associated with longer survival (HR, 0.3; 95% CI, 0.17-0.5; p <0.001). The AUC of the time-dependent ROC curves for the above prognostic scores revealed all of them performed poorly (AUC <0.7).
The seven scoring systems investigated are ineffective at predicting survival in patients with spinal metastasis from lung cancer who are treated non-surgically.
回顾性研究。
本研究旨在观察Tomita评分、修订的Tokuhashi评分、改良的Bauer评分、Van der Linden评分、经典的骨肿瘤研究组（SORG）算法、SORG列线图以及新英格兰脊柱转移瘤评分（NESMS）对非手术治疗的肺癌脊柱转移患者3个月、6个月和1年生存率的预测效果。
尚无研究评估非手术治疗的肺癌脊柱转移患者预后评分的性能。
进行数据分析以确定对生存有显著影响的变量。对于所有接受非手术治疗的肺癌脊柱转移患者，计算Tomita评分、修订的Tokuhashi评分、改良的Bauer评分、Van der Linden评分、经典的SORG算法、SORG列线图以及NESMS。通过在3个月、6个月和12个月时使用受试者工作特征（ROC）曲线评估评分系统的性能。使用ROC曲线下面积（AUC）对评分系统的预测准确性进行量化。
本研究共纳入127例患者。总体研究人群的中位生存期为5.3个月（95%置信区间[CI]，3.7 - 9.6个月）。低血红蛋白与较短生存期相关（风险比[HR]，1.49；95% CI，1.00 - 2.23；p = 0.049），而脊柱转移后接受靶向治疗与较长生存期相关（HR，0.34；95% CI，0.21 - 0.51；p < 0.001）。在多变量分析中，靶向治疗与较长生存期独立相关（HR，0.3；95% CI，0.17 - 0.5；p < 0.001）。上述预后评分的时间依赖性ROC曲线的AUC显示所有评分系统的表现均较差（AUC < 0.7）。
所研究的七种评分系统在预测非手术治疗的肺癌脊柱转移患者的生存方面无效。
