title: Factors Associated with Life Expectancy in Patients with Metastatic Spine Disease from Adenocarcinoma of the Lung.
abstract: Study Design Retrospective study. Objective Our objective was to identify preoperative prognostic factors associated with survival in patients with spinal metastasis from lung carcinoma. Methods A retrospective analysis of 26 patients diagnosed with lung carcinoma metastatic to the spinal column was performed to determine factors associated with survival. We used 3 months survival as the clinical cutoff for whether surgical intervention should be performed. We analyzed patients who survived less than 3 months compared with those who survived more than 3 months. Demographic, preoperative, operative, and postoperative factors including functional scores were collected for analysis. Results The median survival for all patients in our study was 3.5 months. We found a statistically significant difference between the group that survived less than 3 months and the group that survived greater than 3 months in terms of extrathoracic metastasis, visceral metastasis, and average postoperative modified Rankin score. Conclusion Determining which patients with lung cancer spinal metastases will benefit from surgical intervention is often dictated by the patient's predicted life expectancy. Factors associated with poorer prognosis include age, functional status, visceral metastases, and extrathoracic metastases. Although the prognosis for patients with lung cancer spinal metastases is poor, some patients may experience long-term benefit from surgical intervention.
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: C Rory
authors.initials: CR
authors.lastname: Goodwin
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Khattab
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Sankey
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Elder
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Kosztowski
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sarabia-Estrada
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Ali
authors.initials: A
authors.lastname: Bydon
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Witham
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
keywords: adenocarcinoma; life expectancy; lung cancer; metastasis; prognostic factors; spine; surgery; tumor