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- Title
Quality of life and functional outcomes after surgery for spinal metastases: Results of a cohort study.
- Authors
Westermann, Leonard; Eysel, Peer; Luge, Hannah; Olivier, Alain; Oikonomidis, Stavros; Baschera, Dominik; Zarghooni, Kourosh
- Abstract
<bold>Background: </bold>Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours.<bold>Objective: </bold>This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort.<bold>Methods: </bold>A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6 weeks postoperatively, and 3, 6, and 12 months postoperatively.<bold>Results: </bold>Ninety-two patients (mean age, 62.7 ± 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n= 18; 19.6%), lung cancer (n= 16; 17.4%), prostate cancer (n= 14; 15.2%), and breast cancer (n= 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6-7.6) to 3 months (mean, 5.5; 95% CI, 4.8-6.2; p= 0.01) and 12 months (mean, 4.6; 95% CI, 3.7-5.5; p= 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5-57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1-49.6; p= 0.03), 3 months (mean, 37.0; 95% CI, 31.0-42.9) 6 months mean, 40.5; 95% CI, 34.2-46.8; p= 0.01), and 12 months (mean, 31.9; 95% CI, 24.8-39.1; p= 0.005) postoperatively. Improvements in the COMI at 6 weeks (p= 0.05), and 6 months (p= 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38-0.59; p= 0.002), 3 months (mean, 0.50; 95% CI, 0.38-0.61; p= 0.009), and 12 months (mean, 0.61; 95% CI, 0.51-0.71; p= 0.001) postoperatively. After 6 months, the difference was not significant (p= 0.08).<bold>Conclusion: </bold>Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.
- Subjects
METASTASIS; TUMOR diagnosis; COHORT analysis; QUESTIONNAIRES; TUMORS; LUMBAR vertebrae surgery; LENGTH of stay in hospitals; AGE distribution; SURGICAL complications; DISABILITY evaluation; SEX distribution; QUALITY of life; BODY mass index; SPINAL tumors; LONGITUDINAL method
- Publication
Technology & Health Care, 2020, Vol 28, Issue 3, p303
- ISSN
0928-7329
- Publication type
journal article
- DOI
10.3233/THC-191727