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The Effect of Adding Biological Factors to the Decision-Making Process for Spinal Metastasis of Non-Small Cell Lung Cancer
- Source :
- Journal of Clinical Medicine, Volume 10, Issue 5, Journal of Clinical Medicine, Vol 10, Iss 1119, p 1119 (2021)
- Publication Year :
- 2021
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2021.
-
Abstract
- Molecular target therapies have markedly improved the survival of non-small cell lung cancer (NSCLC) patients, especially those with epidermal growth factor receptor (EGFR) mutations. A positive EGFR mutation is even more critical when the chronicity of spinal metastasis is considered. However, most prognostic models that estimate the life expectancy of spinal metastasis patients do not include these biological factors. We retrospectively reviewed 85 consecutive NSCLC patients who underwent palliative surgical treatment for spinal metastases to evaluate the following: (1) the prognostic value of positive EGFR mutation and the chronicity of spinal metastasis, and (2) the clinical significance of adding these two factors to an existing prognostic model, namely the New England Spinal Metastasis Score (NESMS). Among 85 patients, 38 (44.7%) were EGFR mutation-positive. Spinal metastasis presented as the initial manifestation of malignancy in 58 (68.2%) patients. The multivariate Cox proportional hazard model showed that the chronicity of spinal metastasis (hazard ratio (HR) = 1.88, p = 0.015) and EGFR mutation positivity (HR = 2.10, p = 0.002) were significantly associated with postoperative survival. The Uno’s C-index and time-dependent AUC 6 months following surgery significantly increased when these factors were added to NESMS (p = 0.004 and p = 0.022, respectively). In conclusion, biological factors provide an additional prognostic value for NSCLC patients with spinal metastasis.
- Subjects :
- Oncology
medicine.medical_specialty
decompression
lcsh:Medicine
Malignancy
survival
Article
03 medical and health sciences
0302 clinical medicine
New England Spinal Metastasis Score
Internal medicine
medicine
Clinical significance
Epidermal growth factor receptor
Lung cancer
non-small cell lung cancer
biology
Proportional hazards model
business.industry
Hazard ratio
lcsh:R
General Medicine
medicine.disease
spinal metastasis
030220 oncology & carcinogenesis
biology.protein
Uno’s C-index
Spinal metastasis
Non small cell
prognosis
business
epidermal growth factor receptor
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....e1ece0c2f3b112cb5630d2175de00d90
- Full Text :
- https://doi.org/10.3390/jcm10051119