关键词: 脊柱肿瘤, 肺肿瘤, 肿瘤转移, 外科手术, 生存分析

Abstract: Objective： To explore the efficacy of surgical treatment and the prognosis factors of spinal metastases secondary to lung cancer. Methods: From April 2005 to April 2012, 35 patients diagnosed as spinal metastases secondary to lung cancer were reviewed retrospectively. All the patients were divided into surgical group and conservative group. Severity of pain, neurological status and quality of life preoperatively and postoperatively were compared; and the relevance between their survival time and radiotherapy, medical therapy (chemotherapy and/or targeted therapy), surgical treatment, quality of life, and neurological status were evaluated. Results: Of all the patients, 28 (80%, 28/35) had been followed up. The surgical group contained 22 cases and the conservative group 6. The severity of pain and quality of life improved significantly in the surgical group. The median of visual analog scale for pain reduced from 7 points to 3 points (z=4.143, P<0.05); the median of Karnorfsky performance score increased from 50 points to 60 points (z=3.825, P<0.05). For the 13 patients in the surgical group who had neurological deterioration, the improvement of Frankel grade was statistically different (z=2.530, P<0.05). The survival analysis indicated that medical therapy had significant association with longer survival (P=0.001). However, surgery, radiotherapy, neurological status and quality of life had no direct relations with survival time. Conclusion: Surgical treatment for spinal metastases secondary to lung cancer can effectively relieve the pain, improve the quality of life and neurological status. The survival time is largely influenced by medical therapy.

Key words: Spinal neoplasms, Lung neoplasms, Neoplasm metastasis, Surgical procedures, operative, Survival analysis