title: [Efficacy and survival rate analysis of lung cancer with spinal metastases].
abstract: OBJECTIVE
  To explore the efficacy of surgical treatment and the prognosis factors of spinal metastases secondary to lung cancer.
  
  
  METHODS
  From April 2005 to April 2012, 35 patients diagnosed as spinal metastases secondary to lung cancer were reviewed retrospectively. All the patients were divided into surgical group and conservative group. Severity of pain, neurological status and quality of life preoperatively and postoperatively were compared; and the relevance between their survival time and radiotherapy, medical therapy (chemotherapy and/or targeted therapy), surgical treatment, quality of life, and neurological status were evaluated.
  
  
  RESULTS
  Of all the patients, 28 (80%, 28/35) had been followed up. The surgical group contained 22 cases and the conservative group 6. The severity of pain and quality of life improved significantly in the surgical group. The median of visual analog scale for pain reduced from 7 points to 3 points (z = 4.143, P < 0.05); the median of Karnorfsky performance score increased from 50 points to 60 points (z = 3.825, P < 0.05). For the 13 patients in the surgical group who had neurological deterioration, the improvement of Frankel grade was statistically different (z = 2.530, P < 0.05). The survival analysis indicated that medical therapy had significant association with longer survival (P = 0.001). However, surgery, radiotherapy, neurological status and quality of life had no direct relations with survival time.
  
  
  CONCLUSIONS
  Surgical treatment for spinal metastases secondary to lung cancer can effectively relieve the pain, improve the quality of life and neurological status. The survival time is largely influenced by medical therapy.
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.forename: Xiao-guang
authors.initials: XG
authors.lastname: Liu
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.forename: Feng-liang
authors.initials: FL
authors.lastname: Wu
authors.forename: Lei
authors.initials: L
authors.lastname: Dang
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology; D010146:Pain; D010147:Pain Measurement; D011184:Postoperative Period; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000401:mortality* / Q000556:secondary; D016019:Survival Analysis; D015996:Survival Rate