Page 36 - Predicting survival in patients with spinal bone metastasesL
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                                CHAPTER III
Table 1. Six risk factors used in the four predictive models.
      Tomita
   Tokuhashi
  Vd Linden
    Bauer
 Primary tumor
Karnofsky performance status Visceral metastases Extraspinal bone metastases Number spinal metastases Frankel classification
X X XX X X
X X XX X X X X X X
X
 Since life expectancy is of such great influence on therapeutic decision-making, its accurate prediction is of the utmost importance.
The goal of this study is to retrospectively identify clinically relevant risk factors for estimating survival in 106 patients who were surgically treated in a ten-year period at our two centers.
MATERIALS AND METHODS
Patients
All patients who were surgically treated for symptomatic SEM between January 2001 and December 2010 by one surgical team in two tertiary referral centers in the Netherlands were included. Forty-seven patients were operated at the Leiden University Medical Center and 59 at the Medical Center Haaglanden. The surgical team performed the spinal interventions in both hospitals. Surgical treatment was defined as all invasive procedures, aimed at palliation or control of symptoms of SEM. These procedures consisted of percutaneous vertebroplasty, intralesional decompression, partial or complete corpectomy and a single en bloc resection, either through an anterior, posterior or combined approach. Choice of technique and approach were dependent on location of the metastasis, possibilities of fixation on adjacent levels, expected survival and surgeon preference.
Table 2 shows all baseline characteristics of the study population. One patient died during surgery due to myocardial infarction and was excluded from the analysis. For reasons of completeness, the patient is mentioned in the complication summary. A total of 106 patients were included in the study, 53 male and 53 female. The mean age at surgery was 59.0 years. The most commonly affected part
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