Surgical Outcome and Prognosis of Patients with Spinal Metastasis from Esophageal Cancer: The Experience from a Single Center
Surgical Outcome and Prognosis of Patients with Spinal Metastasis from Esophageal Cancer: The Experience from a Single Center
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DOI：
10.1016/j.wneu.2023.05.092
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发表时间：
2023-08-04
影响因子：
2
通讯作者：
Xiao，Jianru
中科院分区：
文献类型：
--
作者：
Wang，Ting;Liu，Jialiang;Xiao，Jianru
背景：脊柱是食管癌转移的常见部位之一，其预后较其他部位差。然而，转移性脊柱食管癌（MSEC）的确切机制尚不清楚，可能是由于患者的生存时间较短。本研究的目的是评估MSEC患者的手术结果和影响预后的因素。方法回顾性研究2013 - 2020年在我院连续接受手术治疗的MSEC患者20例。采用视觉模拟评分法和美国脊髓损伤协会评分法评估手术对患者生活质量的影响。通过单因素和多因素分析确定与传统临床参数、炎症和营养指标相关的预后变量。结果MSEC患者的中位生存时间为6个月，1年生存率为20%。大多数患者疼痛缓解，部分患者术后神经功能恢复。临床因素分析显示，肿瘤全切除有利于MSEC患者的总生存期。红细胞沉降率、中性粒细胞/淋巴细胞比率、血小板/淋巴细胞比率等实验室指标被确定为MSEC患者的独立预后因素。结论及时的手术干预可提高MSEC患者的生活质量。术前红细胞沉降率、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值有助于预测MSEC患者的总生存期。这些发现可能有助于MSEC患者的治疗决策。
BackgroundThe spine is one of the common sites of esophageal cancer metastasis, with a worse prognosis than that of metastasis occurring in other sites. However, the exact mechanism underlying metastatic spinal esophageal cancer (MSEC) is poorly understood possibly due to the short survival time of patients. The aim of this study was to evaluate surgical outcomes and factors affecting the prognosis of patients with MSEC.MethodsEnrolled in this retrospective study were 20 consecutive patients who received surgical treatment for MSEC in our hospital from 2013 to 2020. The impact of surgery on patient's quality of life was assessed by visual analog scale score and American Spinal Injury Association grade. Prognostic variables relative to traditional clinical parameters and inflammation and nutrition indicators were identified by univariate and multivariate analyses.ResultsThe median survival time of patients with MSEC was 6 months, with a one-year survival rate of 20%. Pain relief was achieved in most patients, and nerve function was recovered in part of the patients after surgery. Analysis of clinical factors showed that total tumor resection was beneficial to overall survival of patients with MSEC. Laboratory indicators of erythrocyte sedimentation rate, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were identified as independent prognostic factors for patients with MSEC.ConclusionsTimely surgical intervention can improve the quality of life of patients with MSEC. The preoperative erythrocyte sedimentation rate, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio could help predict the overall survival of patients with MSEC. These findings may help in decision-making for the treatment of patients with MSEC.