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- Title
Predicting Tumor Specific Survival in Patients With Metastatic Spine Disease: Which Scoring System is Most Appropriate?
- Authors
Ahmed, A. Karim; Goodwin, C. Rory; Heravi, Amir; Rachel Kim; Abu-Bonsrah, Nancy; Sankey, Eric W.; De la Garza Ramos, Rafael; Mehta, Vikram; Berry-Candelario, John; Pennington, Zachary; Schwab, Joseph; Molina, Camilo; Sciubba, Daniel M.
- Abstract
Introduction: Despite advances in spinal oncology, research into patient-based prognostic calculators for metastatic spine disease is lacking. Much of the literature in this area investigates the general predictive accuracy of scoring systems in a heterogeneous population. The aim of the current study was to compare the ability of widespread scoring systems to estimate both overall survival at various time points and tumor-specific survival for patients undergoing surgical treatment for metastatic spine disease in order to provide surgeons with information to determine the most appropriate scoring system for a specific patient and timeline. Material and Methods: Patients who underwent surgical resection for metastatic spine disease at a single institution were included. A pre-operative score for all 176 patients was calculated utilizing the SORG Classic Scoring algorithm, SORG Nomogram, Original Tokuhashi, Revised Tokuhashi, Tomita, Original Bauer, Modified Bauer, Katagiri, and van der Linden scoring systems. Univariate and multivariate cox proportional hazard models were constructed to assess the association of patient variables with survival. Receiver operating characteristic analysis (ROC) modeling was utilized to quantify the accuracy of each test at different end-points and for different primary tumor subgroups. Results: Among all patients surgically treated for metastatic spine disease, the SORG Nomogram demonstrated the highest accuracy at predicting 30-day (AUC 0·81), and 90-day (AUC 0·70) survival following surgery. The Original Tokuhashi was the most accurate at predicting 365-day survival (AUC 0·78). Multivariate analysis demonstrated multiple pre-operative factors strongly associated with survival following surgery for spinal metastasis. The accuracy of each scoring system in determining survival probability relative to primary tumor etiology and time elapsed since surgery was assessed. Conclusion: The findings of this study may guide surgeons in selecting the most appropriate scoring system for survival estimation at different postoperative time points for a given patient with known primary disease.
- Publication
Global Spine Journal, 2018, Vol 8, p81S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771030