title: Factors associated with improved survival following surgical treatment for metastatic prostate cancer in the spine: retrospective analysis of 29 patients in a single center.
abstract: BACKGROUND
  Prostate cancer (PCa) is very common and frequently metastasizes to the spine. However, PCa spinal metastases were rarely reported in the literature. In this study, the outcome of therapies and prognostic factors affecting surgical outcomes for patients with PCa spinal metastases are discussed to select the best candidates for aggressive surgical resection.
  
  
  METHODS
  All patients affected by the spinal metastatic PCa surgically treated at our spine tumor center were reviewed. Overall survival was analyzed from the time of spinal surgery. A univariate survival analysis and a multivariate Cox proportional hazard analysis to identify independent prognostic factors were carried out. The survival rate was estimated by the Kaplan-Meier method, and differences were analyzed by the log-rank test. Factors with P values of 0.1 or less were subjected to multivariate analysis for survival rate by multivariate Cox proportional hazard analysis.
  
  
  RESULTS
  A total of 31 consecutive patients were identified. Of these, 29 underwent surgical resection. The median survival time of all patients after their spinal surgery was 44.0 months. Visceral metastases, revised Tokuhashi scores (0-8/9-11/12-15), Tomita scores (7-10/2-6), hormone status, and bisphosphonate treatment were suggested as the potential prognostic factors through univariate analysis. As they were submitted to the multivariate Cox regression model, visceral metastases and Tomita score were found as independent prognostic factors.
  
  
  CONCLUSIONS
  Patients without visceral metastases and a Tomita score no more than 6 are favorable prognostic factors for PCa metastases in the mobile spine.
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. mengtong@medmail.com.cn.
authors.forename: Tong
authors.initials: T
authors.lastname: Meng
authors.affiliation: Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Nanzhe
authors.initials: N
authors.lastname: Zhong
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Tianqi
authors.initials: T
authors.lastname: Fan
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University, Shanghai First People's Hospital, No. 100 Haining Road, Shanghai, 200080, China.
authors.forename: Huabin
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Zhenxi
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of Orthopedics, Shanghai Jiao Tong University, Shanghai First People's Hospital, No. 100 Haining Road, Shanghai, 200080, China. osongdianwen@126.com.
authors.forename: Dianwen
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. ojianruxiao@126.com.
authors.forename: Jianru
authors.initials: J
authors.lastname: Xiao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Prognostic factors; Prostate cancer; Spinal metastases; Surgical outcomes; Survival analysis