Hodgson Sam, Pynsent Paul, Hughes Simon, Rehousek Petr, Gardner Adrian
Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK.
BMC Res Notes. 2025 Jul 22;18(1):316. doi: 10.1186/s13104-025-07390-1.
The prognostic assessment of metastatic spinal disease is predominantly tumour, rather than patient based. In 2021, Baumber et al. published a prognostic scoring system based on the patient as a whole rather than the tumour within the patient for metastatic disease of the appendicular skeleton. This paper assesses that prediction formula in those with metastatic disease of the spine.
Survival was recorded for 65 individuals who underwent surgery for spinal metastatic disease. Using the same parameters and hazard ratio as Baumber, the projected survival was longer than actually occurred (over-prediction of 39% at 6 months and 54% at 12 months). The relative contributions of the individual parameters as part of the overall survival was different between the groups with a greater contribution seen if the individual had hyponatraemia, hypoalbuminaemia and low levels of creatinine. The reasons for the differences seen between the spinal and appendicular groups with regards to these parameters are not clear but may represent a poorer level of general health or the behaviour of different types and subtypes of malignancy. Further work is required to develop a specific tool for the calculation of prognosis in a metastatic spinal cohort using a general health perspective.
转移性脊柱疾病的预后评估主要基于肿瘤，而非患者个体。2021年，鲍姆伯等人发表了一种基于患者整体而非患者体内肿瘤的预后评分系统，用于评估四肢骨骼转移性疾病。本文对该预测公式在脊柱转移性疾病患者中的应用进行评估。
记录了65例接受脊柱转移性疾病手术患者的生存情况。使用与鲍姆伯相同的参数和风险比，预测的生存期比实际生存期更长（6个月时高估39%，12个月时高估54%）。各参数作为总生存期一部分的相对贡献在不同组之间存在差异，如果个体存在低钠血症、低白蛋白血症和低肌酐水平，则贡献更大。脊柱组和四肢组在这些参数方面存在差异的原因尚不清楚，但可能代表总体健康水平较差或不同类型及亚型恶性肿瘤的行为特点。需要进一步开展工作，从总体健康角度开发一种用于计算脊柱转移患者队列预后的特定工具。
