{"title":"脊柱转移手术后早期死亡率的术前预测。","authors":"Hiroto Kamoda,Toshinori Tsukanishi,Hideyuki Kinoshita,Yoko Hagiwara,Yuji Endo,Hiroki Takahashi,Kosuke Takeda,Tetsuya Hirashima,Takeshi Ishii,Tsukasa Yonemoto","doi":"10.1093/jjco/hyae125","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nThe objective of this study was to provide a convenient preoperative prediction of the risk of early postoperative mortality.\r\n\r\nMATERIALS AND METHODS\r\nThis retrospective study included patients who underwent surgery for spinal metastasis at our hospital between 2009 and 2021. Preoperative blood test data of all patients were collected, and the survival time was calculated by dividing the blood data. A multivariate analysis was conducted using a Cox proportional hazards model to identify prognostic factors.\r\n\r\nRESULTS\r\nThe study population included 83 patients (average: 64.5 years), 22 of whom died within 3 months. The most common lesion was the thoracic spine, and incomplete paralysis was observed in 57 patients. The surgical methods included posterior implant fixation (n = 17), posterior decompression (n = 31), and posterior decompression with fixation (n = 35). In the univariate analysis, the presence of abnormal values was significantly associated with postoperative survival in six preoperative blood collection items (hemoglobin, C-reactive protein, albumin, white blood cell, gamma-glutamyl transpeptidase, and lactate dehydrogenase). In a multivariate analysis, four test items (hemoglobin, C-reactive protein, white blood cell, and lactate dehydrogenase) were identified as independent prognostic factors.Comparing cases with ≥3 abnormal values among the above four items (high-risk group; n = 23) and those with ≤2 (low-risk group; n = 60), there was a significant difference in survival time. In addition, it was possible to predict cases of early death within 3 months after surgery with 73% sensitivity and 89% specificity.\r\n\r\nCONCLUSIONS\r\nThe study showed that four preoperative blood test abnormalities (hemoglobin, C-reactive protein white blood cell, and lactate dehydrogenase) indicated the possibility of early death within 3 months after surgery.","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Preoperative prediction of early mortality after surgery for spinal metastases.\",\"authors\":\"Hiroto Kamoda,Toshinori Tsukanishi,Hideyuki Kinoshita,Yoko Hagiwara,Yuji Endo,Hiroki Takahashi,Kosuke Takeda,Tetsuya Hirashima,Takeshi Ishii,Tsukasa Yonemoto\",\"doi\":\"10.1093/jjco/hyae125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\r\\nThe objective of this study was to provide a convenient preoperative prediction of the risk of early postoperative mortality.\\r\\n\\r\\nMATERIALS AND METHODS\\r\\nThis retrospective study included patients who underwent surgery for spinal metastasis at our hospital between 2009 and 2021. Preoperative blood test data of all patients were collected, and the survival time was calculated by dividing the blood data. A multivariate analysis was conducted using a Cox proportional hazards model to identify prognostic factors.\\r\\n\\r\\nRESULTS\\r\\nThe study population included 83 patients (average: 64.5 years), 22 of whom died within 3 months. The most common lesion was the thoracic spine, and incomplete paralysis was observed in 57 patients. The surgical methods included posterior implant fixation (n = 17), posterior decompression (n = 31), and posterior decompression with fixation (n = 35). In the univariate analysis, the presence of abnormal values was significantly associated with postoperative survival in six preoperative blood collection items (hemoglobin, C-reactive protein, albumin, white blood cell, gamma-glutamyl transpeptidase, and lactate dehydrogenase). In a multivariate analysis, four test items (hemoglobin, C-reactive protein, white blood cell, and lactate dehydrogenase) were identified as independent prognostic factors.Comparing cases with ≥3 abnormal values among the above four items (high-risk group; n = 23) and those with ≤2 (low-risk group; n = 60), there was a significant difference in survival time. In addition, it was possible to predict cases of early death within 3 months after surgery with 73% sensitivity and 89% specificity.\\r\\n\\r\\nCONCLUSIONS\\r\\nThe study showed that four preoperative blood test abnormalities (hemoglobin, C-reactive protein white blood cell, and lactate dehydrogenase) indicated the possibility of early death within 3 months after surgery.\",\"PeriodicalId\":14656,\"journal\":{\"name\":\"Japanese journal of clinical oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Japanese journal of clinical oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jjco/hyae125\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese journal of clinical oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jjco/hyae125","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Preoperative prediction of early mortality after surgery for spinal metastases.
OBJECTIVE
The objective of this study was to provide a convenient preoperative prediction of the risk of early postoperative mortality.
MATERIALS AND METHODS
This retrospective study included patients who underwent surgery for spinal metastasis at our hospital between 2009 and 2021. Preoperative blood test data of all patients were collected, and the survival time was calculated by dividing the blood data. A multivariate analysis was conducted using a Cox proportional hazards model to identify prognostic factors.
RESULTS
The study population included 83 patients (average: 64.5 years), 22 of whom died within 3 months. The most common lesion was the thoracic spine, and incomplete paralysis was observed in 57 patients. The surgical methods included posterior implant fixation (n = 17), posterior decompression (n = 31), and posterior decompression with fixation (n = 35). In the univariate analysis, the presence of abnormal values was significantly associated with postoperative survival in six preoperative blood collection items (hemoglobin, C-reactive protein, albumin, white blood cell, gamma-glutamyl transpeptidase, and lactate dehydrogenase). In a multivariate analysis, four test items (hemoglobin, C-reactive protein, white blood cell, and lactate dehydrogenase) were identified as independent prognostic factors.Comparing cases with ≥3 abnormal values among the above four items (high-risk group; n = 23) and those with ≤2 (low-risk group; n = 60), there was a significant difference in survival time. In addition, it was possible to predict cases of early death within 3 months after surgery with 73% sensitivity and 89% specificity.
CONCLUSIONS
The study showed that four preoperative blood test abnormalities (hemoglobin, C-reactive protein white blood cell, and lactate dehydrogenase) indicated the possibility of early death within 3 months after surgery.
期刊介绍:
Japanese Journal of Clinical Oncology is a multidisciplinary journal for clinical oncologists which strives to publish high quality manuscripts addressing medical oncology, clinical trials, radiology, surgery, basic research, and palliative care. The journal aims to contribute to the world"s scientific community with special attention to the area of clinical oncology and the Asian region.
JJCO publishes various articles types including:
・Original Articles
・Case Reports
・Clinical Trial Notes
・Cancer Genetics Reports
・Epidemiology Notes
・Technical Notes
・Short Communications
・Letters to the Editors
・Solicited Reviews