Page 37 - Predicting survival in patients with spinal bone metastasesL

of the spine was the thoracic region (56%). During the course of treatment for the symptomatic SEM, 9 patients underwent systemic treatment (i.e. chemotherapy and/or hormone therapy), 31 patients received radiation therapy, and 55 patients received both. Thirty patients had radiation therapy preoperatively and 56 postoperatively. Forty-seven patients had no sign of neurologic deficit, indicating they were referred either for persisting pain, a pathologic fracture or for instability of the spinal column. The most prevalent primary tumors were breast (n=25), lung (n=20), kidney (n=19) and prostate (n=11) (table 3).
Table 2. Patient characteristics. SD: standard deviation.
Gender Male
Female
Age (mean, years, SD)
Center LUMC
MCH
Location symptomatic spinal metastasis Cervical
Thoracic Lumbar
Adjuvant therapy SEM, perioperatively None
Systemic Therapy Radiation Therapy Both
Neurologic deficit
No (Frankel grade E)
Yes (Frankel grade A, B, C, D)
III
SURGICAL COHORT
Characteristic
Number (%)
53 (50) 53 (50)
59.0 ± 10.9
47 (44) 59 (56)
23 (22) 60 (56) 23 (22)
11 (10) 9 (9) 31 (29) 55 (52)
47 (44) 59 (56)
Table 3. Primary tumors and median survival for each primary. *Median could not be calculated, mean is given.
Primary tumor
Number (%)
Median survival (95% CI)
Breast Lung Kidney Prostate Colon Sarcomas Melanoma Thyroid Rectum Esophagus Pharynx Other
25 (23) 20 (18) 19 (18) 11 (10) 6 (6)
5 (5) 4 (4) 3 (3) 2 (2) 2 (2) 2 (2) 7 (7)
34.7 (11.8 – 46.8) 6.9 (0.0 – 21.6) 14.9 (7.2 – 22.8) 9.2 (1.2 – 16.8) 1.7 (0.0 – 13.2) 8.8 (4.8 – 13.2) 3.4 (0.0 – 7.2) 35.6* (-)
2.1 (-)
3.9 (-)
7.2 (-)
2.7 (1.2 – 3.6)
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