The emergence of new prognostic scores in lung cancer patients with spinal metastasis: A 12-year single-center retrospective study.
The emergence of new prognostic scores in lung cancer patients with spinal metastasis: A 12-year single-center retrospective study.
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肺癌脊柱转移患者新预后评分的出现：12年单中心回顾性研究
DOI：
10.7150/jca.60821
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发表时间：
2021
影响因子：
3.9
通讯作者：
Dong J
中科院分区：
文献类型：
--
作者：
Chen Q;Chen X;Zhou L;Chen F;Hu A;Wang K;Liang H;Jiang L;Li X;Dong J
目的：肺癌患者表现出来自特定人群的脊柱转移，通过这项研究，我们的目的是开发一种可以预测这一特定人群生存的模型。方法：回顾性收集2009年至2021年在我中心接受脊柱转移瘤手术的83例肺癌患者的资料。在对治疗和评分效果进行初步评估后，通过识别和整合关键预后因素创建生存预测诺模图，然后使用一致性指数（C指数）测量一致性，最后使用受试者工作特征曲线（ROC）比较三种现有模型的预测准确性。结果：术后平均生存14.7个月。手术治疗显著改善了肺癌脊柱转移患者的VAS和Frankel评分。修订后的Tokuhashi评分低估了这些患者的预期寿命。六个独立的预后因素，包括年龄，椎管外骨转移灶，内脏转移，Frankel评分，靶向治疗和放疗，被确定并纳入模型。3个月、6个月和12个月总生存率的校准曲线显示预测风险与实际风险之间具有良好的一致性。队列研究的列线图C指数为0.800（95%置信区间[CI]：0.757-0.843）。模型比较表明，诺模图的预测精度优于修正的Tokuhashi和Bauer的评分系统。结论：脊柱手术为患者提供了恢复神经功能的可能性。在确定了现有评分系统的缺点后，我们重新创建并验证了一种新的诺模图，该诺模图可用于预测肺癌脊柱转移患者的生存结局，从而帮助脊柱外科医生做出手术决策并为这些患者提供个性化治疗。
Objective: Lung cancer patients exhibit spinal metastases from a specific population, and with this study, we aimed to develop a model that can predict this particular group's survival. Methods: Data were retrospectively collected from 83 lung cancer patients who underwent spinal metastasis surgery at our center from 2009 to 2021. After the initial assessment of treatment and scoring effects, a nomogram for survival prediction was created by identifying and integrating critical prognostic factors, followed by a consistency index (C-index) to measure consistency, and finally, a subject working characteristic curve (ROC) to compare the predictive accuracy of the three existing models. Results: The mean postoperative survival was 14.7 months. Surgical treatment significantly improved the VAS and Frankel scores in lung cancer patients with spinal metastases. The revised Tokuhashi score underestimated the life expectancy of these patients. Six independent prognostic factors, including age, extraspinal bone metastasis foci, visceral metastasis, Frankel score, targeted therapy, and radiotherapy, were identified and incorporated into the model. Calibration curves for 3-, 6-, and 12-month overall survival showed a good concordance between predicted and actual risk. The nomogram C-index for the cohort study was 0.800 (95% confidence interval [CI]: 0.757-0.843). Model comparisons showed that the nomogram's prediction accuracy was better than revised Tokuhashi and Bauer's scoring systems. Conclusions: Spine surgery offered patients the possibility of regaining neurological function. Having identified shortcomings in existing scoring systems, we have recreated and validated a new nomogram that can be used to predict survival outcomes in patients with spinal metastases from lung cancer, thereby assisting spinal surgeons in making surgical decisions and personalizing treatment for these patients.
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影响因子：
51.1
作者：
Mitsudomi, Tetsuya;Morita, Satoshi;Fukuoka, Masahiro
通讯作者：
Fukuoka, Masahiro
影响因子：
3
作者：
TOKUHASHI, Y;MATSUZAKI, H;OHSAKA, S
通讯作者：
OHSAKA, S
影响因子：
45.3
作者：
Miller, Vincent A.;Riely, Gregory J.;Johnson, David H.
通讯作者：
Johnson, David H.
影响因子：
3
作者：
WONG, DA;FORNASIER, VL;MACNAB, I
通讯作者：
MACNAB, I
DOI：
10.1212/con.0000000000000551
发表时间：
2017-12-01
期刊：
Continuum (Minneapolis, Minn.)
影响因子：
--
作者：
Pruitt, Amy A
通讯作者：
Pruitt, Amy A