[Prognosis after surgical treatment of spinal metastases due to lung cancer]

Abstract

Background: Patients with spine metastases due to lung cancer suffer from a reduced lifespan. For a more precise prognosis, it is important to define parameters which influence the individual survival time. This study reviewed the mean survival time of patients who had undergone surgery because of spine metastases due to lung cancer. It should be evaluated whether the postsurgical survival time is dependent on the length of time between diagnosis and surgery and from the histological type of the tumor.

Material and methods: Between January 1999 and December 2003, 68 patients had undergone spine surgery because of spine metastases due to lung cancer at the department of traumatology of the St. Georg General Hospital in Hamburg, Germany. Retrospective data were collected from the hospital documentary system regarding the period between diagnosis of lung cancer and date of surgical treatment, and regarding the histological type of the tumor. The postsurgical survival times were evaluated using data from the Hamburger Cancer Index and from general practitioners. These times were analysed afterward according to the defined parameters.

Results: The average age was 62.6 years, and 24 female and 44 male patients were included. It was possible to evaluate the survival time of 65 patients. The average survival time of those with preoperative unknown primary manifestation (20 patients) was 88 days, in the group of patients with lung cancer histories of less than 12 months (35 patients) 141 days, and with patients with lung cancer histories of lung cancer longer than 12 months (13 patients) it was 171 days. The mean survival times after surgical treatment were 122 days for patients suffering from non-small-cell lung cancer (45 patients), 128 days for those with small-cell lung cancer (20 patients), and 247 days for patients with other histological types (three patients).

Discussion: The prognosis of patients after spine surgery for lung cancer metastases is poor. The indication for surgical treatment of spinal metastases due to lung cancer should be critically discussed. Especially patients with unknown primary manifestation might benefit from a conservative approach. With respect to the patients' reduced lifespan, they, their relatives, and the nursing staff should be carefully informed.