TY - JOUR

T1 - Conditional survival after surgery for metastatic tumors of the spine

T2 - does prognosis change over time?

AU - Zaborovskii, Nikita

AU - Schlauch, Adam

AU - Shapton, John

AU - Denisov, Anton

AU - Ptashnikov, Dmitrii

AU - Mikaylov, Dmitrii

AU - Masevnin, Sergei

AU - Smekalenkov, Oleg

AU - Murakhovsky, Vladislav

AU - Kondrashov, Dimitriy

N1 - © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2023/3

Y1 - 2023/3

N2 - PURPOSE: Conditional survival (CS) provides a dynamic prediction of patient survival by incorporating the time an individual has already survived given their disease specific characteristics. The objective of the current study was to estimate CS among patients after surgery for spinal cord compression or spinal instability, as well as stratify CS according to relevant patient- and disease-related characteristics.METHODS: The clinical outcomes of 361 patients undergoing surgical management of metastatic spinal tumors were retrospectively analyzed. Stratification of this cohort according to disease and surgery-specific characteristics allowed for univariate and multivariate statistical analyses of our study population. Observed overall and conditional survival estimates were calculated by the Kaplan-Meier method.RESULTS: 12-month conditional survival in patients undergoing surgical management of metastatic spine tumors increased from 57% at baseline to 70% at 24 months following spine surgery. Overall survival (OS) was influenced by CCI grade, Katagiri tumor type, presence of lung metastasis, type of spine surgery, presence of postoperative systemic therapy and ambulatory status at follow-up. Analyses of OS and CS by prognostic strata were similar with exception of stratification by surgery type. Differences in survival between strata tend to converge over time. Unfavorable factors for OS appear to be less relevant after a period of 24 months following spine surgery.CONCLUSION: Patients after surgery for metastatic tumors of the spine can expect a positive trend in conditional survival as survivorship increases. Even patients with a more severe disease can be encouraged with gains in conditional survival over time.LEVEL OF EVIDENCE: Level IV (retrospective cohort study).

AB - PURPOSE: Conditional survival (CS) provides a dynamic prediction of patient survival by incorporating the time an individual has already survived given their disease specific characteristics. The objective of the current study was to estimate CS among patients after surgery for spinal cord compression or spinal instability, as well as stratify CS according to relevant patient- and disease-related characteristics.METHODS: The clinical outcomes of 361 patients undergoing surgical management of metastatic spinal tumors were retrospectively analyzed. Stratification of this cohort according to disease and surgery-specific characteristics allowed for univariate and multivariate statistical analyses of our study population. Observed overall and conditional survival estimates were calculated by the Kaplan-Meier method.RESULTS: 12-month conditional survival in patients undergoing surgical management of metastatic spine tumors increased from 57% at baseline to 70% at 24 months following spine surgery. Overall survival (OS) was influenced by CCI grade, Katagiri tumor type, presence of lung metastasis, type of spine surgery, presence of postoperative systemic therapy and ambulatory status at follow-up. Analyses of OS and CS by prognostic strata were similar with exception of stratification by surgery type. Differences in survival between strata tend to converge over time. Unfavorable factors for OS appear to be less relevant after a period of 24 months following spine surgery.CONCLUSION: Patients after surgery for metastatic tumors of the spine can expect a positive trend in conditional survival as survivorship increases. Even patients with a more severe disease can be encouraged with gains in conditional survival over time.LEVEL OF EVIDENCE: Level IV (retrospective cohort study).

KW - Humans

KW - Retrospective Studies

KW - Prognosis

KW - Spine/surgery

KW - Lung Neoplasms

KW - Spinal Cord Compression/etiology

U2 - 10.1007/s00586-023-07548-0

DO - 10.1007/s00586-023-07548-0

M3 - Article

C2 - 36708397

VL - 32

SP - 1010

EP - 1020

JO - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

IS - 3

ER -