• C Rory Goodwin, Meghan Price, Andrea N Goodwin, Tara Dalton, Anne L Versteeg, Arjun Sahgal, Laurence D Rhines, James M Schuster, Michael H Weber, Aron Lazary, Stefano Boriani, Chetan Bettegowda, Michael G Fehlings, Paul M Arnold, Nicolas Dea, Raphaele Charest-Morin, John Shin, Ilya Laufer, Dean Chou, Ziya L Gokaslan, Michelle J Clarke, Charles G Fisher, Daniel M Sciubba, and AO Spine Knowledge Forum Tumor.
• Department of Neurosurgery. Spine Division. Duke Center for Brain and Spine Metastasis. Duke University Medical Center, Durham, NC.
• Spine. 2023 Dec 27.

Study DesignRetrospective review of prospective, multicenter and international cohort study.ObjectiveTo describe the effect of gender on HRQoL, clinical outcomes and survival for patients with spinal metastases treated with either surgery and/or radiation.Summary Of Background DataGender differences in health-related outcomes are demonstrated in numerous studies, with women experiencing worse outcomes and receiving lower standards of care than men, however, the influence that gender has on low health-related quality of life (HRQoL) and clinical outcomes after spine surgery remains unclear.MethodsPatient demographic data, overall survival, treatment details, perioperative complications, and HRQoL measures including EQ-5D, pain NRS, the short form 36 version 2 (SF-36v2) and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0) were reviewed. Patients were stratified by sex, and a separate sensitivity analysis that excluded gender-specific cancers (i.e., breast, prostate, etc.) was performed.ResultsThe study cohort included 207 female and 183 male patients, with age, smoking status, and site of primary cancer being significantly different between the two cohorts (P<0.001). Both males and females experienced significantly improved SOSGOQ2.0, EQ-5D, and pain NRS scores at all study time points from baseline (P<0.001). Upon sensitivity analysis, (gender-specific cancers removed from analysis), the significant improvement in SOSGOQ physical, mental, and social subdomains and on SF-36 domains disappeared for females. Males experienced higher rates of postoperative complications. Kaplan-Meier survival analysis of both the overall and sensitivity analysis cohorts showed females lived longer than males after treatment (P=0.001 and 0.043, respectively).ConclusionBoth males and females experienced significantly improved HRQoL scores after treatment, but females demonstrated longer survival and a lower complication rate. This study suggests that gender may be a prognostic factor in survival and clinical outcomes for patients undergoing treatment for spine metastases and should be taken into consideration when counseling patients accordingly.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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