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Prognostic Factor Analysis in Patients with Metastatic Spine Disease Depending on Surgery and Conservative Treatment: Review of 577 Cases

 Byung Ho Lee  ;  Tae-Hwan Kim  ;  Hyun-Soo Chong  ;  Eun-Soo Moon  ;  Jin-Oh Park  ;  Hak-Sun Kim  ;  Seung-Hyun Kim  ;  Hwan-Mo Lee  ;  Yong-jin Cho  ;  Keung Nyun Kim  ;  Seong-Hwan Moon 
 ANNALS OF SURGICAL ONCOLOGY, Vol.20(1) : 40-46, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Back Pain/etiology ; Breast/pathology* ; Colorectal Neoplasms/pathology* ; Combined Modality Therapy ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms/pathology* ; Lung Neoplasms/pathology* ; Male ; Middle Aged ; Neck Pain/etiology ; Neoplasm Metastasis ; Proportional Hazards Models ; Radiculopathy/etiology ; Retrospective Studies ; Sex Factors ; Spinal Neoplasms/complications ; Spinal Neoplasms/secondary* ; Spinal Neoplasms/surgery ; Spinal Neoplasms/therapy* ; Young Adult
Primary Cancer ; Spinal Metastasis ; Radicular Pain ; Postoperative Survival ; Conservative Group
Background To date, skillful medical management and advanced surgical techniques have provided increased quality of life with less postoperative morbidity in patients with spinal metastasis. We assessed the survival of patients with spinal metastasis according to two treatment modalities: surgery and conservative treatment. Methods From 2005 to 2010, a total of 577 patients (200 surgery, 377 conservative treatment) who had spinal metastasis were enrolled. Prognostic factors and survival were assessed by Cox regression and Kaplan–Meier analyses in patients receiving either surgery or conservative treatment. Results The mean age was 59.7 (range 21–87) years in the surgery group and 59.9 (range 28–90) years in the conservative treatment group. The major primary cancers were of lung, liver, and colorectal origin in the surgery group and lung, liver, and breast in the conservative group. The mean ± SD Tokuhashi score in the surgery group was 8.12 ± 3.09 and in the conservative group was 8.0 ± 2.8 (not significant). The hazard ratio of the primary cancer group ranged from 1.870 to 3.217 compared to that of the most favorable primary cancer group in all patients. Survival was affected significantly by sex, adjuvant therapy, and postoperative survival in the surgery group and by clinical symptom, metastasis to major internal organ, and primary cancer origin in the conservative group. Conclusions With this retrospective review of 577 cases of spinal metastasis, different prognostic factors depending on the treatment modality were discovered. Hence, consideration of these factors depending on the treatment modality could be helpful in treating patients with spinal metastasis.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0002-3878-1944
Kim, Tae Hwan(김태환)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Moon, Eun Su(문은수)
Park, Jin Oh(박진오)
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chong, Hyon Su(정현수)
Cho, Yong Jin(조용진)
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