A New Treatment Strategy for Spinal Metastasis: The "Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology" Decision Framework System

Cao，Xuyong1,2; Jiang，Weihao1,2; Zhang，Bin1; Zhao，Xiongwei2,3; Yu，Haikuan1,4; Lei，Mingxing4,5,6; Cao，Yuncen2; Su，Xiuyun7; Liu，Yaosheng1,2,3,6

2024-03-01

10.1227/neu.0000000000002709

Neurosurgery   影响因子和分区

1524-4040

BACKGROUND AND OBJECTIVES: Treating metastatic spinal tumors poses a significant challenge because there are currently no universally applied guidelines for managing spinal metastases. This study aims to propose a new decision framework for the 12-point epidural spinal cord compression grading system to treat patients with metastatic spinal tumors and investigate its clinical effectiveness in a multicenter analysis. METHODS: This study analyzed 940 patients with metastatic spinal tumors between December 2017 and March 2023. The study provided the clinical evidence for the systemic conditions, effectiveness of systemic treatment, neurology, and oncology (SENO) decision framework among spine metastases. The SENO decision framework was launched in January 2021 in our hospitals, classifying patients into 2 groups: The non-SENO group (n = 489) consisted of patients treated between December 2017 and January 2021, while the SENO group (n = 451) comprised patients treated from January 2021 to March 2023. RESULTS: Patients in the SENO group were more likely to receive minimally invasive surgery (67.85% vs 58.69%) and less chance of receiving spinal cord circular decompression surgery (14.41% vs 24.74%) than patients in the non-SENO group ( P < .001). Furthermore, patients in the SENO group experienced fewer perioperative complications (9.09% vs 15.34%, P = .004), incurred lower hospitalization costs ( P < .001), had shorter length of hospitalization ( P < .001), and received systematic treatments for tumors earlier ( P < .001). As a result, patients in the SENO group (329.00 [95% CI: 292.06-365.94] days) demonstrated significantly improved survival outcomes compared with those in the non-SENO group (279.00 [95% CI: 256.91-301.09], days) ( P < .001). At 3 months postdischarge, patients in the SENO group reported greater improvements in their quality of life, encompassing physical, social, emotional, and functional well-being, when compared with patients in the non-SENO group. CONCLUSION: The SENO decision framework is a promising approach for treating patients with metastatic spinal tumors.

英语

其他

CLINICAL MEDICINE

2-s2.0-85185221470

Scopus

1.Senior Department of Orthopedics,Fourth Medical Center of PLA General Hospital,China
2.Department of Orthopedic Surgery,Fifth Medical Center of PLA General Hospital,China
3.Department of Orthopedic Surgery,Fifth School of Clinical Medicine,Anhui Medical University,China
4.Chinese PLA Medical School,China
5.Department of Orthopedic Surgery,Hainan Hospital of PLA General Hospital,China
6.Department of Orthopedic Surgery,National Clinical Research Center for Orthopedics,Sports Medicine & Rehabilitation,PLA General Hospital,China
7.Southern University of Science and Technology Hospital,Shenzhen,China

Cao，Xuyong,Jiang，Weihao,Zhang，Bin,et al. A New Treatment Strategy for Spinal Metastasis: The "Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology" Decision Framework System[J]. Neurosurgery,2024,94(3):584-596.

Cao，Xuyong.,Jiang，Weihao.,Zhang，Bin.,Zhao，Xiongwei.,Yu，Haikuan.,...&Liu，Yaosheng.(2024).A New Treatment Strategy for Spinal Metastasis: The "Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology" Decision Framework System.Neurosurgery,94(3),584-596.

Cao，Xuyong,et al."A New Treatment Strategy for Spinal Metastasis: The "Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology" Decision Framework System".Neurosurgery 94.3(2024):584-596.