Introduction: Patients diagnosed with lung cancer spinal metastases have poor patient prognoses. Surgical intervention for spinal metastases is considered when overall life expectancy is greater than 3 months. Many studies have identified prognostic factors utilizing a heterogeneous group of tumor subtypes, however few studies have analyzed lung cancer alone.
Methods: A retrospective analysis of twenty-six patients diagnosed with lung carcinoma metastatic to the spinal column was performed to determine factors associated with survival. Using the clinical cutoff for whether surgical intervention should be employed of 3 months, we stratified patients into survivors less than three months and survivors greater than three months for analysis. Demographic, preoperative, operative and postoperative factors including functional scores were collected for analysis.
Results: The median survival for all patients in our study was 3.5 months. We found that there was a statistically significant difference between the less than 3 month survival group and the greater than 3 month survival group in terms of extra-thoracic metastasis, visceral metastasis, and average postoperative modified Rankin Score.
Conclusions: Determining which patients with lung cancer spinal metastases will benefit from surgical intervention is often dictated by the patient’s predicted life expectancy. Factors associated with poorer prognosis include age, functional status, visceral metastases, and extra-thoracic metastases. Although the prognosis for patients with lung cancer spinal metastases is poor, some patients may benefit long term from surgical intervention.
Patient Care: This research provides surgeons with information to effectively counsel patients and determine appropriate treatment paradigms based on factors associated with greater than 3 month life expectancy for patients diagnosed with lung cancer spinal metastases.
Learning Objectives: By the conclusion of this session, participants should be able to identify pre-operative prognostic factors associated with survival in patients with spinal metastasis from lung carcinoma.
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