Post-operative complications affect survival in surgically treated metastatic spinal cord compression
© 2024. The Author(s) under exclusive licence to SICOT aisbl..
PURPOSE: The prevalence of metastatic epidural spinal cord compression (MESCC) is increasing globally due to advancements in cancer diagnosis and treatment. Whilst surgery can benefit specific patients, the complication rate can reach up to 34%, with limited reporting on their impact in the literature. This study aims to analyse the influence of major complications on the survival of surgically treated MESCC patients.
METHODS: Consecutive MESCC patients undergoing surgery and meeting inclusion criteria were selected. Survival duration from decompressive surgery to death was recorded. Perioperative factors influencing survival were documented and analysed. Kaplan-Meier survival analysis at one year compared these factors. Univariate and multivariate Cox proportional hazard regression analyses were performed. Additionally, univariate analysis compared complicated and uncomplicated groups.
RESULTS: Seventy-five patients were analysed. Median survival for this cohort was 229 days (95% CI 174-365). Surgical complications, low patient performance, and rapid primary tumour growth were significant perioperative variables for survival in multivariate analyses (p < 0.001, p = 0.003, and p = 0.02, respectively) with a hazard ratio of 3.2, 3.6, and 2.1, respectively. Univariate analysis showed no variables associated with complication occurrence.
CONCLUSION: In this cohort, major surgical complications, patient performance, and primary tumour growth rate were found to be independent factors affecting one year survival. Thus, prioritizing complication prevention and appropriate patient selection is crucial for optimizing survival in this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
International orthopaedics - 48(2024), 5 vom: 11. Apr., Seite 1341-1350 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
González-Kusjanovic, Nicolás [VerfasserIn] |
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| Links: |
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| Themen: |
Cohort study |
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| Anmerkungen: |
Date Completed 10.04.2024 Date Revised 23.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00264-024-06120-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369621808 |
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| 520 | |a © 2024. The Author(s) under exclusive licence to SICOT aisbl. | ||
| 520 | |a PURPOSE: The prevalence of metastatic epidural spinal cord compression (MESCC) is increasing globally due to advancements in cancer diagnosis and treatment. Whilst surgery can benefit specific patients, the complication rate can reach up to 34%, with limited reporting on their impact in the literature. This study aims to analyse the influence of major complications on the survival of surgically treated MESCC patients | ||
| 520 | |a METHODS: Consecutive MESCC patients undergoing surgery and meeting inclusion criteria were selected. Survival duration from decompressive surgery to death was recorded. Perioperative factors influencing survival were documented and analysed. Kaplan-Meier survival analysis at one year compared these factors. Univariate and multivariate Cox proportional hazard regression analyses were performed. Additionally, univariate analysis compared complicated and uncomplicated groups | ||
| 520 | |a RESULTS: Seventy-five patients were analysed. Median survival for this cohort was 229 days (95% CI 174-365). Surgical complications, low patient performance, and rapid primary tumour growth were significant perioperative variables for survival in multivariate analyses (p < 0.001, p = 0.003, and p = 0.02, respectively) with a hazard ratio of 3.2, 3.6, and 2.1, respectively. Univariate analysis showed no variables associated with complication occurrence | ||
| 520 | |a CONCLUSION: In this cohort, major surgical complications, patient performance, and primary tumour growth rate were found to be independent factors affecting one year survival. Thus, prioritizing complication prevention and appropriate patient selection is crucial for optimizing survival in this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cohort study | |
| 650 | 4 | |a Decompressive surgery | |
| 650 | 4 | |a Spinal cord compression | |
| 650 | 4 | |a Spine metastases | |
| 650 | 4 | |a Surgical complications | |
| 650 | 4 | |a Survival analysis | |
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| 700 | 1 | |a Vidal, Catalina |e verfasserin |4 aut | |
| 700 | 1 | |a Campos, Mauricio |e verfasserin |4 aut | |
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