Health- related quality of life after surgery for spinal metastases

IF 3.4 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-03-15 DOI:10.1016/j.jbo.2025.100675

Silvia Terzi , Cristiana Griffoni , Simona Rosa , Chiara Cini , Emanuela Asunis , Chiara Alcherigi , Federica Trentin , Stefano Bandiera , Riccardo Ghermandi , Giuseppe Tedesco , Gisberto Evangelisti , Marco Girolami , Valerio Pipola , Giovanni Barbanti Brodano , Alessandro Gasbarrini

{"title":"Health- related quality of life after surgery for spinal metastases","authors":"Silvia Terzi , Cristiana Griffoni , Simona Rosa , Chiara Cini , Emanuela Asunis , Chiara Alcherigi , Federica Trentin , Stefano Bandiera , Riccardo Ghermandi , Giuseppe Tedesco , Gisberto Evangelisti , Marco Girolami , Valerio Pipola , Giovanni Barbanti Brodano , Alessandro Gasbarrini","doi":"10.1016/j.jbo.2025.100675","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Surgery for spinal metastases is almost always palliative and part of a multidisciplinary approach that has determined a significant increase of life expectancy in the last decade; thus, an improvement in health-related quality of life (HRQOL) is the main goal of the treatment of spinal metastases. We report here the results of a prospective study conducted with the aim of evaluating the impact of spinal surgery on HRQOL, measured by Patient-Reported Outcomes Measures (PROMs). We analyzed clinical outcomes (ambulatory status, performance status, pain, neurological status) and HRQOL scores (VAS, EQ5D, SF36) during the follow-up period and focused on factors that could affect quality of life, considering both psychological and physical issues.</div></div><div><h3>Methods</h3><div>169 patients (96 males, 73 females) with vertebral metastases who underwent surgery at a tertiary referral center were consecutively enrolled from August 2018 to October 2022. Clinical and surgical data were prospectively collected, and PROMs (VAS, EQ-5D and SF-36) were registered before surgery and during follow up.</div></div><div><h3>Results</h3><div>The overall survival was 22 months, and a 61 % survival rate was registered at 1 year follow-up. We observed a significant improvement in walking ability, general performance status, pain and HRQOL after surgery, which was maintained during the follow up. Multivariate analysis identified three independent variables, capable of influencing the trend of HRQOL after surgery: the presence of pathological fracture, the preoperative neurological status and the local recurrence of disease.</div></div><div><h3>Discussion</h3><div>This study confirms the effectiveness of surgery for spinal metastases in improving patients’ performance status and demonstrates an overall improvement in HRQOL, which is maintained over time.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100675"},"PeriodicalIF":3.4000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Bone Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212137425000168","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Surgery for spinal metastases is almost always palliative and part of a multidisciplinary approach that has determined a significant increase of life expectancy in the last decade; thus, an improvement in health-related quality of life (HRQOL) is the main goal of the treatment of spinal metastases. We report here the results of a prospective study conducted with the aim of evaluating the impact of spinal surgery on HRQOL, measured by Patient-Reported Outcomes Measures (PROMs). We analyzed clinical outcomes (ambulatory status, performance status, pain, neurological status) and HRQOL scores (VAS, EQ5D, SF36) during the follow-up period and focused on factors that could affect quality of life, considering both psychological and physical issues.

Methods

169 patients (96 males, 73 females) with vertebral metastases who underwent surgery at a tertiary referral center were consecutively enrolled from August 2018 to October 2022. Clinical and surgical data were prospectively collected, and PROMs (VAS, EQ-5D and SF-36) were registered before surgery and during follow up.

Results

The overall survival was 22 months, and a 61 % survival rate was registered at 1 year follow-up. We observed a significant improvement in walking ability, general performance status, pain and HRQOL after surgery, which was maintained during the follow up. Multivariate analysis identified three independent variables, capable of influencing the trend of HRQOL after surgery: the presence of pathological fracture, the preoperative neurological status and the local recurrence of disease.

Discussion

This study confirms the effectiveness of surgery for spinal metastases in improving patients’ performance status and demonstrates an overall improvement in HRQOL, which is maintained over time.

查看原文本刊更多论文

脊柱转移术后与健康相关的生活质量

脊柱转移的手术几乎总是姑息性的，并且是多学科方法的一部分，在过去十年中，这已经决定了预期寿命的显着增加；因此，改善与健康相关的生活质量（HRQOL）是脊柱转移治疗的主要目标。我们在此报告一项前瞻性研究的结果，目的是评估脊柱手术对HRQOL的影响，通过患者报告的结果测量（PROMs）来衡量。我们分析了随访期间的临床结果（运动状态、运动状态、疼痛、神经状态）和HRQOL评分（VAS、EQ5D、SF36），并将心理和生理问题考虑在内，重点关注可能影响生活质量的因素。方法2018年8月至2022年10月，在三级转诊中心接受手术治疗的169例椎体转移患者（男性96例，女性73例）连续入选。前瞻性收集临床和手术资料，在手术前和随访期间登记PROMs （VAS、EQ-5D、SF-36）。结果总生存期为22个月，随访1年生存率为61%。我们观察到术后行走能力、一般运动状态、疼痛和HRQOL的显著改善，并在随访期间保持。多因素分析确定了影响术后HRQOL趋势的三个自变量：病理性骨折的存在、术前神经系统状况和疾病的局部复发。本研究证实了脊柱转移手术在改善患者运动状态方面的有效性，并证明了HRQOL的整体改善，并且这种改善可以长期保持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.