title: [Comprehensive assessment of the outcomes of surgical treatment of patients with metastatic spinal cord injuries].
abstract: Every year the number of cancer patients increases due to increased life expectancy. According to various sources, metastases in the spine are found during autopsy in 30-90% of patients with a history of cancer. So far, there have been no full-scale studies of the quality of life of patients with various metastatic tumors of the spine who underwent surgical treatment in Russian literature. The main objective of this study was to demonstrate the need for implementing the comprehensive treatment of patients with metastases in the spine and target setting as the main tool to identify the factors that adversely affect the patients' quality of life.
  
  
  
  The quality of life of 56 patients aged 16 to 81 years was assessed, including 26 males and 30 females. Twenty-six patients underwent surgical treatment between 2002 and 2009, and thirty patients underwent surgical treatment between 2009 and 2014. Kidney cancer was a primary disease in 30.3% of patients, multiple myeloma was a primary disease in 23.1% of cases, and the primary source of a tumor was not identified in cancer screening in 10.5% of cases. There were also isolated cases of melanoma, thymoma, metastases of tumors of the gastrointestinal tract, uterus, ovary, lung, prostate, pancreas, and the thyroid gland, which on the average amounted to 3.5% (1.8 to 7.14%). The quality of life of patients was studied using the EORTC QLQ C30 scale. The patients were surveyed prior to the surgery and then 1, 3, 6 and 12 months after surgical treatment during 1 year or until death. Preoperative and postoperative contrast-enhanced SCT and MRI examinations were used to control the extent of decompression of neural structures.
  
  
  
  On the basis of these findings, the authors identified the main factors affecting the quality of life of patients and formulated a range of treatment goals for patients with metastases in the spine.
  
  
  
  Surgical treatment has a positive effect on the quality of life of patients with metastases in the spine. However, it is not a key factor in the context of survival rate of these patients. Therefore, a decision on the possibility and necessity of surgical treatment should be taken in cooperation with the patient and oncologists of different specialties.
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: N A
authors.initials: NA
authors.lastname: Konovalov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia; Clinical Hospital #1, Moscow, Russia.
authors.forename: A G
authors.initials: AG
authors.lastname: Nazarenko
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: D S
authors.initials: DS
authors.lastname: Asyutin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Solenkova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: R A
authors.initials: RA
authors.lastname: Onoprienko
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: B A
authors.initials: BA
authors.lastname: Zakirov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: S Yu
authors.initials: SY
authors.lastname: Timonin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: I U
authors.initials: IU
authors.lastname: Cherkiev
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Martynova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Kosyr'kova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: V A
authors.initials: VA
authors.lastname: Korolishin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011184:Postoperative Period; D011788:Quality of Life; D013125:Spinal Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery; D016896:Treatment Outcome