Abstract
BACKGROUND CONTEXT
As the prevalence of spinal metastasis rises, methods to predict survival will become
increasingly important for clinical decision-making. Sarcopenia may be used to predict
survival in these patients.
PURPOSE
The purpose of this study to develop a prediction model incorporating sarcopenia for
postoperative survival in patients with spinal metastasis.
DESIGN
Retrospective cohort study
PATIENT SAMPLE
This included 200 patients who underwent operative intervention for spinal metastasis
in our institution, a tertiary, academic spine center.
OUTCOME MEASURES
The primary outcome measure was 1-year postoperative survival. The secondary outcome
measures were 3 month and 6 month postoperative survival.
METHODS
Clinicopathological and survivorship data was collated. Sarcopenia was defined using
the L3 Psoas/Vertebral Body Ratio on cross-sectional CT. Independent predictors of
postoperative survival were assessed by multiple logistic regression.
RESULTS
Overall 1-year postoperative survival was 50%. L3/Psoas ratio ≥1.5 (OR 6.2), albumin
≥35g/l (OR 3.0) and primary tumor type were found to be independent predictors of
3 month, 6 month and 1 year postoperative survival on multivariable analysis. Age
at surgery, ambulatory status and mode of presentation were not independent predictors
of survival. Variables were used to generate a new scoring system, ProgMets, to predict
postoperative survival. The ProgMets system had greater correlation and higher area
under the curve (AUC, 0.80) for 1-year survival than other scoring systems.
CONCLUSIONS
This is the first model to incorporate sarcopenia to predict survival in spinal metastasis
patients and has good prediction of survival compared to previous models. This tool
may be increasingly useful for informed decision making for patients and surgeons.
Keywords
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Article info
Publication history
Published online: April 26, 2023
Accepted:
April 18,
2023
Received in revised form:
March 2,
2023
Received:
November 20,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: FJM: Nothing to disclose. JPM: Nothing to disclose. OM: Consulting: Stryker (C); NuVasive (C); Medtronic (A).
Identification
Copyright
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