• Kazuyoshi Kobayashi, Kei Ando, Hiroaki Nakashima, Koji Sato, Tokumi Kanemura, Hisatake Yoshihara, Atsuhiko Hirasawa, Fumihiko Kato, Naoki Ishiguro, and Shiro Imagama.
• Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
• Spine. 2020 Jul 1; 45 (13): E813-E819.

Study DesignRetrospective study.ObjectiveThe purpose of the study was to examine survival after surgery for a metastatic spinal tumor using prognostic factors in the new Katagiri score.Summary Of Background DataSurgery for spinal metastasis can improve quality of life and facilitate treatment of the primary cancer. However, choice of therapy requires identification of prognostic factors for survival, and these may change over time due to treatment advances. The new Katagiri score for the prognosis of skeletal metastasis includes classification of the primary tumor site and the effects of chemotherapy and hormonal therapy.MethodsThe subjects were 201 patients (127 males, 74 females) who underwent surgery for spinal metastases at six facilities in the Nagoya Spine Group. Age at surgery, gender, follow-up, metastatic spine level, primary cancer, new Katagiri score (including primary site, visceral metastasis, laboratory data, performance status (PS), and chemotherapy) and survival were obtained from a prospectively maintained database.ResultsPosterior decompression (n = 29) and posterior decompression and fixation with instrumentation (n = 182) were performed at a mean age of 65.9 (range, 16-85) years. Metastasis was present in the cervical (n = 19, 10%), thoracic (n = 155, 77%), and lumbar (n = 26, 13%) spine, and sacrum (n = 1, 1%). In multivariate analysis, moderate growth (HR 2.95, 95% CI, 1.27-7.89, P < 0.01) and rapid growth (HR 4.71, 95% CI, 2.78-12.31, P < 0.01) at the primary site; nodular metastasis (HR 1.53, 95% CI, 1.07-3.85, P < 0.01) and disseminated metastasis (HR 2.94, 95% CI, 1.33-5.42, P < 0.01); and critical laboratory data (HR 3.15, 95% CI, 2.06-8.36, P < 0.01), and poor PS (HR 2.83, 95% CI, 1.67-4.77, P < 0.01) were significantly associated with poor survival.ConclusionAccurate prognostic factors are important in deciding the treatment strategy in patients with spinal metastasis, and our identification of these factors may be useful for these patients.Level Of Evidence3.

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