Impact of surgical intervention on quality of life in patients with spinal metastases.
METHODS
Prospective clinical study.


OBJECTIVE
To assess Health-Related Quality of Life outcomes in patients undergoing surgery for spinal metastases.


BACKGROUND
Increasing life expectancy of patients with spinal metastases has resulted in greater interest in overall quality of life, including pain and neurologic impairment. To assess the overall risks and benefits of surgical intervention, the overall impact of each on the overall health status must be assessed.


METHODS
All patients who presented to a single institution with bony spinal metastases requiring surgical intervention were eligible.


METHODS
previous surgery for spinal metastases, primary tumors of the spine, and inability to fill out the questionnaires. Patients completed an EORTC QLQ-C30, the HUI-3, the EQ-5D, visual analog pain, and an ECOG functional assessment. at five points: before surgery and at 6 weeks, 3 months, 6 months, and 1 year post surgery.


RESULTS
Of 96 patients who presented to the hospital, 85 were enrolled in the study. Average age was 58.6 years (range, 20.3-80.7 years) with 47 male patients; 50% survival as 39.1 weeks. Maximal and average VAS pain levels showed a statistically significant (P < 0.00001) improvement from preoperative to all postoperative time points. Only the QLQ-C30 global health status showed a statistically significant improvement from preoperative to the 6-week (P = 0.017), 3-month (P = 0.039), and 6-month (P = 0.013) time points. There was a statistically significant correlation between baseline global health status and survival time (P = 0.041). Overall distribution of HUI-3 utility calculated Quality of Life Adjusted Years (QALY) during the 1-year postoperative period showed a bimodal distribution with peaks at 0.1 and 0.7 years.


CONCLUSIONS
Surgery for patients with spinal metastases offers decreased pain and improved quality of life with low rates of surgical complications.
Falicov
Alexis
A
Vancouver Spine Program, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Fisher
Charles G
CG
Sparkes
Joe
J
Boyd
Michael C
MC
Wing
Peter C
PC
Dvorak
Marcel F
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000401:mortality / Q000523:psychology / Q000556:secondary* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome