BACKGROUND This study was to develop an algorithm capable of predicting the survival of patients with NSCLC spinal metastasis for individualized therapy. METHODS We identified 176 consecutive patients with NSCLC spinal metastasis between 2006 and 2017. Twenty-four features, including age, gender, smoking, KPS, paralysis, histological subtype, tumor stage, surgery, EGFR status, CEA, CA125, CA19-9, NSE, SCC, CYFRA21-1, calcium, AKP, albumin, the number of spinal, extra-spinal bone and visceral metastasis, time to metastasis, pathological fracture, and primary or secondary metastasis, were retrospectively analyzed. Features associated with survival in the multivariate analyses were included in a scoring model, which was prospectively validated in another 63 patients (NCT03363685). RESULTS The median follow-up period was 12.00 months (interquartile range 6.00-23.40 months). One hundred forty-seven patients died during follow-up, with a median survival of 13.6 months being observed. Multivariate analysis revealed that the following features were associated with survival: age, smoking, CA125, SCC, KPS, and EGFR status. A scoring system based on these features was created to stratify patients into low-risk (0-3), intermediate-risk (4-6) and high-risk (7-10) groups, whose estimated median survival times 29.10, 10.40 and 3.90 months, respectively. The Harrell's c-index was 0.72. Model validation supported this model's validity and reproducibility. CONCLUSIONS In patients with NSCLC spinal metastasis, survival was associated with age, smoking, CA125, SCC, KPS, and EGFR status. A validated scoring system based on these features was devised that can predict the survival times of those patients. This scoring system provides a basis for applying the NOMS framework and for facilitating individual treatment.

中文翻译：

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非小细胞肺癌脊柱转移患者新型生存预测评分算法的建立与验证。

背景技术本研究旨在开发一种能够预测NSCLC脊柱转移瘤患者个体化生存率的算法。方法我们确定了2006年至2017年之间连续176例NSCLC脊柱转移患者。其二十四项特征包括年龄，性别，吸烟，KPS，瘫痪，组织学亚型，肿瘤分期，手术，EGFR状态，CEA，CA125，CA19-9，回顾性分析NSE，SCC，CYFRA21-1，钙，AKP，白蛋白，脊柱，脊柱外骨和内脏转移的数量，转移时间，病理性骨折以及原发或继发转移。在多变量分析中与生存相关的特征包括在评分模型中，该模型在另外63位患者中得到了前瞻性验证（NCT03363685）。结果中位随访期为12。00个月（四分位数范围6.00-23.40个月）。147例患者在随访中死亡，中位生存期为13.6个月。多变量分析显示以下特征与生存相关：年龄，吸烟，CA125，SCC，KPS和EGFR状态。建立了基于这些特征的评分系统，将患者分为低风险（0-3），中风险（4-6）和高风险（7-10）组，其中位生存时间估计为29.10、10.40和分别为3.90个月。哈雷尔的C指数为0.72。模型验证支持该模型的有效性和可重复性。结论NSCLC脊柱转移患者的生存与年龄，吸烟，CA125，SCC，KPS和EGFR状态有关。设计了基于这些功能的经过验证的评分系统，可以预测这些患者的生存时间。该评分系统为应用NOMS框架和促进个体治疗提供了基础。