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单发性脊柱转移瘤术后的生存及预后因素:孤立性单发性脊柱转移瘤与合并其他转移的单发性脊柱转移瘤的比较

Survival and Prognostic Factors After Surgery in Single Spinal Metastasis: Comparison of Isolated-Single Spinal Metastasis and Single Spinal Metastasis With Other Metastasis.

作者信息

Kim Hyun-Jun, Park Jin-Sung, Park Se-Jun, Kang Dong-Ho, Lee Chong-Suh

机构信息

Department of Orthopedic Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, South Korea.

Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Global Spine J. 2025 May;15(4):2246-2254. doi: 10.1177/21925682241295666. Epub 2024 Oct 19.

Abstract

Study DesignRetrospective cohort study.ObjectivesThis study aimed to evaluate the survival period in patients with a single spinal metastasis (SSM), subsequently comparing those with isolated-single spinal metastasis (I-SSM) and single spinal metastasis with other metastasis (O-SSM) after surgery, and to identify prognostic factors affecting their survival.MethodsA total of 135 patients were included, with 24 patients in the I-SSM group and 111 in the O-SSM group. Survival analysis was utilized to assess the survival of SSM patients, followed by a comparison of survival rates between the two groups. Univariate and multivariate analyses were conducted to identify significant prognostic factors for survival.ResultsThe overall median survival period for patients with single spinal metastasis (SSM) was 10.2 ± 1.8 months. Specifically, the median survival was 15.7 ± 5.7 months in the I-SSM group and 10.2 ± 1.5 months in the O-SSM group. The difference in survival periods between the two groups was not statistically significant ( = 0.345). Significant independent prognostic factors for survival included preoperative Karnofsky Performance Status (KPS) of 50 - 70 (OR 0.51, = 0.017) and 80 - 100 (OR 0.46, = 0.012), postoperative ambulatory status (OR 1.19, = 0.028), and primary malignancy site [Group B (OR 2.67, = 0.021), Group C (OR 2.90, = 0.016)].ConclusionsPatients with SSM have a median survival of 10.2 months, with no significant difference in postoperative survival between the I-SSM and O-SSM groups. Significant prognostic factors influencing the survival period after surgery include preoperative KPS, postoperative ambulatory status, and the primary malignancy site.

摘要

研究设计

回顾性队列研究。

目的

本研究旨在评估单发脊柱转移瘤(SSM)患者的生存期,随后比较手术治疗后孤立性单发脊柱转移瘤(I - SSM)患者与伴有其他转移的单发脊柱转移瘤(O - SSM)患者的生存期,并确定影响其生存的预后因素。

方法

共纳入135例患者,其中I - SSM组24例,O - SSM组111例。采用生存分析评估SSM患者的生存情况,随后比较两组的生存率。进行单因素和多因素分析以确定生存的显著预后因素。

结果

单发脊柱转移瘤(SSM)患者的总体中位生存期为10.2±1.8个月。具体而言,I - SSM组的中位生存期为15.7±5.7个月,O - SSM组为10.2±1.5个月。两组生存期的差异无统计学意义(P = 0.345)。生存的显著独立预后因素包括术前卡氏功能状态(KPS)为50 - 70(OR 0.51,P = 0.017)和80 - 100(OR 0.46,P = 0.012)、术后活动状态(OR 1.19,P = 0.028)以及原发恶性肿瘤部位[B组(OR 2.67,P = 0.021),C组(OR 2.90,P = 0.016)]。

结论

SSM患者的中位生存期为10.2个月,I - SSM组和O - SSM组术后生存率无显著差异。影响术后生存期的显著预后因素包括术前KPS、术后活动状态和原发恶性肿瘤部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3fe/12035180/82739b684e55/10.1177_21925682241295666-fig1.jpg

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