Westermann, Leonard, Eysel, Peer, Luge, Hannah, Olivier, Alain, Oikonomidis, Stavros, Baschera, Dominik and Zarghooni, Kourosh (2020). Quality of life and functional outcomes after surgery for spinal metastases: Results of a cohort study. Technol. Health Care, 28 (3). S. 303 - 315. AMSTERDAM: IOS PRESS. ISSN 1878-7401

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Abstract

BACKGROUND: Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours. OBJECTIVE: This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort. METHODS: A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6 weeks postoperatively, and 3, 6, and 12 months postoperatively. RESULTS: Ninety-two patients (mean age, 62.7 +/- 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n = 18; 19.6%), lung cancer (n = 16; 17.4%), prostate cancer (n = 14; 15.2%), and breast cancer (n = 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6-7.6) to 3 months (mean, 5.5; 95% CI, 4.8-6.2; p = 0.01) and 12 months (mean, 4.6; 95% CI, 3.7-5.5; p = 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5-57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1-49.6; p = 0.03), 3 months (mean, 37.0; 95% CI, 31.0-42.9) 6 months mean, 40.5; 95% CI, 34.2-46.8; p = 0.01), and 12 months (mean, 31.9; 95% CI, 24.8-39.1; p = 0.005) postoperatively. Improvements in the COMI at 6 weeks (p = 0.05), and 6 months (p = 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38-0.59; p = 0.002), 3 months (mean, 0.50; 95% CI, 0.38-0.61; p = 0.009), and 12 months (mean, 0.61; 95% CI, 0.51-0.71; p = 0.001) postoperatively. After 6 months, the difference was not significant (p = 0.08). CONCLUSION: Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Westermann, LeonardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eysel, PeerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luge, HannahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Olivier, AlainUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oikonomidis, StavrosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baschera, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zarghooni, KouroshUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-350689
DOI: 10.3233/THC-191727
Journal or Publication Title: Technol. Health Care
Volume: 28
Number: 3
Page Range: S. 303 - 315
Date: 2020
Publisher: IOS PRESS
Place of Publication: AMSTERDAM
ISSN: 1878-7401
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SURGICAL-TREATMENT; MULTIPLE-MYELOMA; RISK-FACTORS; SURVIVAL; CANCER; DISEASE; PAIN; PREDICTION; TRENDS; IMPACTMultiple languages
Health Care Sciences & Services; Engineering, BiomedicalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/35068

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