Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma
Purpose: The prognosis of hepatocellular carcinoma (HCC) has recently improved, and so clinicians have greater opportunity to treat HCC-derived spinal metastases. Therefore, predicting life expectancy is important for determining the optimal treatment strategy for such tumors. This study aimed to in...
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Online Access: | https://doi.org/10.1177/2309499019899167 |
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doaj-a4b7b2e9d3d546009bc581c9807183242020-11-25T03:23:47ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902020-02-012810.1177/2309499019899167Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinomaHiroshi UeiYasuaki TokuhashiPurpose: The prognosis of hepatocellular carcinoma (HCC) has recently improved, and so clinicians have greater opportunity to treat HCC-derived spinal metastases. Therefore, predicting life expectancy is important for determining the optimal treatment strategy for such tumors. This study aimed to investigate the prognostic factors for HCC-derived metastatic spine tumors and to develop a scoring system for predicting life expectancy in such cases. Methods: The posttreatment survival time and factors that might influence it were investigated in 62 patients with HCC-derived metastatic spine tumors who were treated at our department (surgery: 27 patients and conservative treatment: 35 patients), and a prognostic scoring system for predicting life expectancy was developed by combining the factors that significantly influenced survival. Results: In the univariate analyses, sex, the patient’s general condition, the presence/absence of major internal organ metastasis, the total revised Tokuhashi score, the serum albumin level, Child-Pugh class, spinal surgery, and bone-modifying agent (BMA) treatment were found to influence the posttreatment survival time. These factors were subjected to multivariate analysis, and a novel scoring system for predicting life expectancy based on the patient’s general condition, the serum albumin level (or Child-Pugh class), and BMA treatment was developed. In the retrospective analysis, the concordance rate between the patients’ life expectancy and actual survival times was 90.3%. Conclusion: The patient’s general condition, the serum albumin level (or Child-Pugh class), and BMA treatment influenced the posttreatment survival times of patients with HCC-derived metastatic spine tumors. A prognostic scoring system based on these factors was proposed.https://doi.org/10.1177/2309499019899167 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiroshi Uei Yasuaki Tokuhashi |
spellingShingle |
Hiroshi Uei Yasuaki Tokuhashi Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma Journal of Orthopaedic Surgery |
author_facet |
Hiroshi Uei Yasuaki Tokuhashi |
author_sort |
Hiroshi Uei |
title |
Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
title_short |
Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
title_full |
Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
title_fullStr |
Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
title_full_unstemmed |
Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
title_sort |
prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma |
publisher |
SAGE Publishing |
series |
Journal of Orthopaedic Surgery |
issn |
2309-4990 |
publishDate |
2020-02-01 |
description |
Purpose: The prognosis of hepatocellular carcinoma (HCC) has recently improved, and so clinicians have greater opportunity to treat HCC-derived spinal metastases. Therefore, predicting life expectancy is important for determining the optimal treatment strategy for such tumors. This study aimed to investigate the prognostic factors for HCC-derived metastatic spine tumors and to develop a scoring system for predicting life expectancy in such cases. Methods: The posttreatment survival time and factors that might influence it were investigated in 62 patients with HCC-derived metastatic spine tumors who were treated at our department (surgery: 27 patients and conservative treatment: 35 patients), and a prognostic scoring system for predicting life expectancy was developed by combining the factors that significantly influenced survival. Results: In the univariate analyses, sex, the patient’s general condition, the presence/absence of major internal organ metastasis, the total revised Tokuhashi score, the serum albumin level, Child-Pugh class, spinal surgery, and bone-modifying agent (BMA) treatment were found to influence the posttreatment survival time. These factors were subjected to multivariate analysis, and a novel scoring system for predicting life expectancy based on the patient’s general condition, the serum albumin level (or Child-Pugh class), and BMA treatment was developed. In the retrospective analysis, the concordance rate between the patients’ life expectancy and actual survival times was 90.3%. Conclusion: The patient’s general condition, the serum albumin level (or Child-Pugh class), and BMA treatment influenced the posttreatment survival times of patients with HCC-derived metastatic spine tumors. A prognostic scoring system based on these factors was proposed. |
url |
https://doi.org/10.1177/2309499019899167 |
work_keys_str_mv |
AT hiroshiuei prognosticscoringsystemformetastaticspinetumorsderivedfromhepatocellularcarcinoma AT yasuakitokuhashi prognosticscoringsystemformetastaticspinetumorsderivedfromhepatocellularcarcinoma |
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