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European Spine Journal
Published in: European Spine Journal 4/2018

Open Access 01-04-2018 | Review

A systematic review of prognostic factors predicting survival in patients with spinal bone metastases

Authors: L. Bollen, W. C. H. Jacobs, Y. M. Van der Linden, O. Van der Hel, W. Taal, P. D. S. Dijkstra

Published in: European Spine Journal | Issue 4/2018

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Abstract

Purpose

For the selection of treatment in patients with spinal bone metastases (SBM), survival estimation plays a crucial role to avoid over- and under-treatment. To aid clinicians in this difficult task, several prediction models have been developed, consisting of many different risk factors. The aim of this systematic review was to identify prognostic factors that are associated with survival in patients with SBM to support development of predictive models.

Methods

A systematic review was performed with focus on prognostic factors associated with survival in patients with SBM. Two reviewers independently selected studies for inclusion and assessed the risk of bias. A level of evidence synthesis was performed for each prognostic factor. Inter-observer agreement for the risk of bias assessment was determined by the kappa-statistic.

Results

After screening, 142 full-text articles were obtained, of which 22 met the eligibility criteria. A total of 43 different prognostic factors were investigated in the included studies, of which 17 were relevant to pre-treatment survival estimation. The prognostic factors most frequently associated with survival were the primary tumor and the performance status. The prognostic factors most frequently not associated with survival were age, gender, number and location of the SBM and the presence of a pathologic fracture.

Conclusions

Prognostication for patients with SBM should be based on an accurate primary tumor classification, combined with a performance score. The benefit of adding other prognostic factors is doubtful.
Appendix
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Literature
1.
2.
Loblaw DA, Perry J, Chambers A et al (2005) Systematic review of the diagnosis and management of malignant extradural spinal cord compression. J Clin Oncol 23(9):2028–2037CrossRefPubMed
3.
Mizumoto M, Harada H, Asakura H et al (2011) Radiotherapy for patients with metastases to the spinal column: a review of 603 patients at Shizuoka Cancer Center Hospital. Int J Radiat Oncol Biol Phys 79(1):208–213CrossRefPubMed
4.
Bollen L, van der Linden YM, Pondaag W et al (2014) Prognostic factors associated with survival in patients with symptomatic spinal bone metastases: a retrospective cohort study of 1 043 patients. Neuro-oncology 16(7):991–998CrossRefPubMedPubMedCentral
5.
Rades D, Hueppe M, Schild SE (2013) A score to identify patients with metastatic spinal cord compression who may be candidates for best supportive care. Cancer 119(4):897–903CrossRefPubMed
6.
Helweg-Larsen S, Sørensen PS, Kreiner S (2000) Prognostic factors in metastatic spinal cord compression: a prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients. Int J Radiat Oncol Biol Phys 46(5):1163–1169CrossRefPubMed
7.
Bach F, Larsen BH, Rohde K et al (1990) Metastatic spinal cord compression. Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression. Acta Neurochir 107(1–2):37–43CrossRefPubMed
8.
Van der Linden YM, Dijkstra PDS, Vonk E et al (2005) Prediction of survival in patients with metastases in the spinal column: results based on a randomized trial of radiotherapy. Cancer 103(2):320–328CrossRefPubMed
9.
Chow E, Harth T, Hruby G et al (2001) How accurate are physicians’ clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review. Clin Oncol 13(3):209–218
10.
Tokuhashi Y, Matsuzaki H, Oda H et al (2005) A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine 30(19):2186–2191CrossRefPubMed
11.
Tomita K, Kawahara N, Kobayashi T et al (2001) Surgical strategy for spinal metastases. Spine 26(3):298–306CrossRefPubMed
12.
Leithner A, Radl R, Gruber G et al (2008) Predictive value of seven preoperative prognostic scoring systems for spinal metastases. Eur Spine J 17(11):1488–1495CrossRefPubMedPubMedCentral
13.
Bollen L, Wibmer C, Van der Linden YM et al (2016) Predictive value of six prognostic scoring systems for spinal bone metastases: an analysis based on 1379 patients. Spine 41(3):155–162CrossRef
14.
Hayden JA, Van der Windt DA, Cartwright JL et al (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158:280–286CrossRefPubMed
15.
Karnofsky DA, Abelmann WH, Craver LF et al (1948) The use of the nitrogen mustards in the palliative treatment of carcinoma. With particular reference to bronchogenic carcinoma. Cancer 1:634–656CrossRef
16.
Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed
17.
Frankel HL, Hancock DO, Hyslop G et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I. Spinal Cord 7(3):179–192CrossRef
18.
Ariëns GA, Van Mechelen W, Bongers PM et al (2000) Physical risk factors for neck pain. Scand J Work Environ Health 26(1):7–19CrossRefPubMed
19.
Scholten-Peeters GG, Verhagen AP, Bekkering GE et al (2003) Prognostic factors of whiplash associated disorders: a systematic review of prospective cohort studies. Pain 104(1–2):303–322CrossRefPubMed
20.
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed
21.
Riegel T, Schilling T, Sitter H et al (2002) Analysis of factors affecting the prognosis of vertebral metastases. Zentralbl Neurochir 63(1):2–6CrossRefPubMed
22.
Hosono N, Ueda T, Tamura D et al (2005) Prognostic relevance of clinical symptoms in patients with spinal metastases. Clin Orthop Relat Res 436:196–201CrossRef
23.
Ibrahim A, Crockard A, Antonietti P et al (2008) Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. J Neurosurg J Neurosurg Spine 8(3):271–278CrossRef
24.
Chi JH, Gokaslan Z, McCormick P et al (2009) Selecting treatment for patients with malignant epidural spinal cord compression-does age matter?: results from a randomized clinical trial. Spine 34(5):431–435CrossRefPubMed
25.
Arrigo RT, Kalanithi P, Cheng I et al (2011) Predictors of survival after surgical treatment of spinal metastasis. Neurosurgery 68(3):674–681CrossRefPubMed
26.
Bartels RH, Feuth T, Rades D et al (2011) External validation of a model to predict the survival of patients presenting with a spinal epidural metastasis. Cancer Metastasis Rev 30(2):153–159CrossRefPubMed
27.
Park JH, Rhim SC, Jeon SR (2011) Efficacy of decompression and fixation for metastatic spinal cord compression: analysis of factors prognostic for survival and postoperative ambulation. J Korean Neurosurg Soc 50(5):434–440CrossRefPubMedPubMedCentral
28.
Pointillart V, Vital J-M, Salmi R et al (2011) Survival prognostic factors and clinical outcomes in patients with spinal metastases. J Cancer Res Clin Oncol 137(5):849–856CrossRefPubMed
29.
Wibmer C, Leithner A, Hofmann G et al (2011) Survival analysis of 254 patients after manifestation of spinal metastases: evaluation of seven preoperative scoring systems. Spine 36(23):1977–1986CrossRefPubMed
30.
Chao ST, Koyfman SA, Woody N et al (2012) Recursive partitioning analysis index is predictive for overall survival in patients undergoing spine stereotactic body radiation therapy for spinal metastases. Int J Radiat Oncol Biol Phys 82(5):1738–1743CrossRefPubMed
31.
Kataoka M, Kunisada T, Tanaka M et al (2012) Statistical analysis of prognostic factors for survival in patients with spinal metastasis. Acta Med Okayama 66(3):213–219PubMed
32.
Tancioni F, Navarria P, Pessina F et al (2012) Assessment of prognostic factors in patients with metastatic epidural spinal cord compression (MESCC) from solid tumor after surgery plus radiotherapy: a single institution experience. Eur Spine J 21:146–148CrossRefPubMedCentral
33.
Yang SB, Cho W, Chang U (2012) Analysis of prognostic factors relating to postoperative survival in spinal metastases. J Korean Neurosurg Soc 51(3):127–134CrossRefPubMedPubMedCentral
34.
Balain B, Jaiswal A, Trivedi JM et al (2013) The Oswestry Risk Index: an aid in the treatment of metastatic disease of the spine. Bone Jt J 95-B(2):210–621CrossRef
35.
Tabouret E, Cauvin C, Fuentes S et al (2015) Reassessment of scoring systems and prognostic factors for metastatic spinal cord compression. Spine J. 15(5):944–950CrossRefPubMed
36.
Morgen SS, Nielsen DH, Larsen CF et al (2014) Moderate precision of prognostic scoring systems in a consecutive, prospective cohort of 544 patients with metastatic spinal cord compression. J Cancer Res Clin Oncol 140(12):2059–2064CrossRefPubMed
37.
Yeung YN, Cheung KK, Lam TC (2014) A study of the predictive value of the modified Tokuhashi score in metastatic spinal tumour causing cord compression in a southern Chinese population. J Ort Trauma Rehab. 18(1):15–21
38.
American Society of Anesthesiologists (1963) New classification of physical status. Anesthesiology 24:111
39.
Luksanapruksa P, Buchowski JM, Hotchkiss W et al (2017) Prognostic factors in patients with spinal metastasis: a systematic review and meta-analysis. Spine J 17(5):689–708CrossRefPubMed
Metadata
Title
A systematic review of prognostic factors predicting survival in patients with spinal bone metastases
Authors
L. Bollen
W. C. H. Jacobs
Y. M. Van der Linden
O. Van der Hel
W. Taal
P. D. S. Dijkstra
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 4/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5320-3

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