Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Leithner, A; Radl, R; Gruber, G; Hochegger, M; Leithner, K; Welkerling, H; Rehak, P; Windhager, R.
Predictive value of seven preoperative prognostic scoring systems for spinal metastases.
Eur Spine J. 2008; 17(11): 1488-1495.
Doi: 10.1007/s00586-008-0763-1
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- Führende Autor*innen der Med Uni Graz
- Leithner Andreas
- Windhager Reinhard
- Co-Autor*innen der Med Uni Graz
- Gruber Gerald
- Leithner Katharina
- Radl Roman
- Rehak Peter
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- Abstract:
- Predicting prognosis is the key factor in selecting the proper treatment modality for patients with spinal metastases. Therefore, various assessment systems have been designed in order to provide a basis for deciding the course of treatment. Such systems have been proposed by Tokuhashi, Sioutos, Tomita, Van der Linden, and Bauer. The scores differ greatly in the kind of parameters assessed. The aim of this study was to evaluate the prognostic value of each score. Eight parameters were assessed for 69 patients (37 male, 32 female): location, general condition, number of extraspinal bone metastases, number of spinal metastases, visceral metastases, primary tumour, severity of spinal cord palsy, and pathological fracture. Scores according to Tokuhashi (original and revised), Sioutos, Tomita, Van der Linden, and Bauer were assessed as well as a modified Bauer score without scoring for pathologic fracture. Nineteen patients were still alive as of September 2006 with a minimum follow-up of 12 months. All other patients died after a mean period of 17 months after operation. The mean overall survival period was only 3 months for lung cancer, followed by prostate (7 months), kidney (23 months), breast (35 months), and multiple myeloma (51 months). At univariate survival analysis, primary tumour and visceral metastases were significant parameters, while Karnofsky score was only significant in the group including myeloma patients. In multivariate analysis of all seven parameters assessed, primary tumour and visceral metastases were the only significant parameters. Of all seven scoring systems, the original Bauer score and a Bauer score without scoring for pathologic fracture had the best association with survival (P < 0.001). The data of the present study emphasize that the original Bauer score and a modified Bauer score without scoring for pathologic fracture seem to be practicable and highly predictive preoperative scoring systems for patients with spinal metastases. However, decision for or against surgery should never be based alone on a prognostic score but should take symptoms like pain or neurological compromise into account.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Decision Support Techniques -
- Disease Progression -
- Female -
- Humans -
- Life Expectancy -
- Male -
- Middle Aged -
- Neoplasm Metastasis - diagnosis
- Neoplasm Staging -
- Neurosurgical Procedures - standards
- Predictive Value of Tests -
- Preoperative Care - methods
- Prognosis -
- Prospective Studies -
- Severity of Illness Index -
- Spinal Neoplasms - diagnosis
- Spine - pathology
- Survival Analysis -
- Survival Rate -
- Treatment Outcome -
- Viscera - pathology
- Find related publications in this database (Keywords)
- Spine
- Metastasis
- Survival
- Vertebral bodies
- Cord compression