减压分离手术治疗胸腰椎转移瘤的生存预后分析  

Survival prognostic analysis of decompression and separation surgery for thoracolumbar metastases

作　　者：朱岩 唐鹏 张黎明 索朗达吉 王一村 樊根涛 周光新 Zhu Yan;Tang Peng;Zhang Liming;Suolang Daji;Wang Yicun;Fan Gentao;Zhou Guangxin(Department of Orthopedics,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院骨科,江苏南京210002

出　　处：《实用肿瘤杂志》2024年第5期436-441,共6页Journal of Practical Oncology

基　　金：国家自然科学基金面上项目(82373153,82373305);江苏省自然科学基金面上项目(BK20231505);院内临床专项续航项目(22LCYY-XH1)。

摘　　要：目的探讨减压分离手术治疗胸腰椎转移瘤的临床效果和影响患者生存的预后因素。方法回顾性分析2012年1月至2019年12月于本院接受(n=50)和不接受(n=21)减压分离手术的胸腰椎转移瘤患者的临床和随访资料。采用log-rank检验和Cox回归分析对接受手术的患者进行生存预后的单因素和多因素分析。结果接受手术的患者生存期长于未接受手术的患者[(19.67±2.66)个月vs(13.38±1.40)个月,P=0.039]。多因素分析显示,有无放疗、有无内脏转移、美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分和脊椎转移间期是影响行减压分离手术的胸腰椎转移瘤患者的生存预后的独立因素(均P<0.05)。结论脊椎转移瘤患者预后较差,减压分离手术能够改善患者生存预后。有无放疗、有无内脏转移、ECOG评分和脊椎转移间期是影响行减压分离手术的脊椎转移瘤患者生存预后的重要因素。Objective To explore the therapeutic efficacy and prognostic factors of decompression and separation surgery for thoracolumbar spinal metastases.Methods The clinical and survival data of patients with thoracolumbar spinal metastases who were operated(n=50)and not operated(n=21)at our hospital from January 2012 to December 2019 were retrospectively analysed.Univariate and multivariate analysis of the survival of the patients treated with surgery were done by log-rank test and Cox regression analysis.Results The survival of the patients with surgery was significantly better than that of the patients without surgery[(19.67±2.66)months vs(13.38±1.40)months,P=0.039].Multivariate analysis showed that postoperative radiotherapy,combined visceral metastasis,Eastern Cooperative Oncology Group(ECOG)score and the interval of spinal metastasis were independent prognostic factors affecting the survival prognosis of patients with thoracolumbar spine metastases undergoing decompression and separation surgery(all P<0.05).Conclusions The prognosis is not optimistic for patients with spinal metastases,and decompression and separation surgery can improve the prognosis.Postoperative radiotherapy,combined visceral metastasis,ECOG score and the interval of spinal metastasis are important prognostic factors.

关 键 词：脊椎转移 减压分离手术 放疗 

分 类 号：R738.1[医药卫生—肿瘤]