Aims

Our objective was to determine if preoperative patient-reported assessments are associated with survival after surgery for stabilization of skeletal metastases.

Patients and Methods

All patients with metastatic cancer to bone and indications for skeletal stabilization surgery were approached to participate in a prospective cohort study at a tertiary care center from 2012 to 2017. Of the 208 patients who were eligible, 195 (94%) completed the 36-item Short Form Health Survey (SF-36) preoperatively and underwent surgical treatment of skeletal metastases with complete or impending fractures; the sample encompassed a range of cancer diagnoses and included cases of both internal fixation and endoprosthetic replacement. Cox proportional hazards models were used to identify associations between SF-36 scores and survival.

Results

In a model adjusted for clinical factors, patients’ mental and physical SF-36 component summary scores were significantly associated with survival, as was their SF-36 composite score (P = 0.004, P = 0.015, and P < 0.001, respectively). Scores in the general health, vitality, and mental health domains were each strongly associated with survival (P < 0.001).

Conclusions

Patients’ preoperative assessments of their health status are associated with their survival after surgery for skeletal metastases. Patient-reported assessments have the potential to contribute unique information to models that estimate patient survival, as part of efforts to provide optimal, individualized care and make informed decisions about the type and magnitude of surgery for metastatic bone disease that will last the patient’s lifetime.

中文翻译：

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术前定量患者评估与骨转移的生存和手术结果相关

目标

我们的目的是确定术前患者报告的评估是否与骨骼转移稳定手术后的生存率相关。

患者和方法

2012 年至 2017 年，所有患有骨转移癌且有骨骼稳定手术指征的患者均被邀请参加三级护理中心的一项前瞻性队列研究。在 208 名符合资格的患者中，195 名 (94%) 完成了 36 项研究术前进行简短健康调查（SF-36），并对完全或即将骨折的骨骼转移进行手术治疗；该样本涵盖了一系列癌症诊断，包括内固定和内置假体置换的病例。Cox 比例风险模型用于确定 SF-36 评分与生存之间的关联。

结果

在根据临床因素调整的模型中，患者的精神和身体 SF-36 组成部分汇总评分与生存率显着相关，其 SF-36 综合评分也是如此（分别为 P = 0.004、P = 0.015和 P <  0.001 ）  。一般健康、活力和心理健康领域的得分均与生存密切相关（P  < 0.001）。

结论

患者术前对其健康状况的评估与骨转移术后的生存率相关。患者报告的评估有可能为估计患者生存的模型提供独特的信息，作为提供最佳、个性化护理的努力的一部分，并就将持续患者一生的转移性骨病手术的类型和规模做出明智的决定。