脊柱转移性肿瘤患者术后生存期的影响因素分析

Analysis of Influencing Factors on Postoperative Survival of Patients with Spinal Metastatic Tumors

目的 分析脊柱转移性肿瘤患者术后生存期的影响因素。方法 回顾性选取68例脊柱转移性肿瘤患者,所有患者均行外科手术治疗。术后随访2年,统计患者生存、死亡情况,并据此分为死亡组和生存组。收集患者一般临床资料,单因素及多因素Logistic分析脊柱转移性肿瘤患者术后生存期的影响因素。结果 2组年龄、性别、吸烟、体重指数(BMI)、原发肿瘤、合并基础疾病、累及椎体数、术中出血量比较,差异无统计学意义(P>0.05);死亡组原发肿瘤进展迅速、原发肿瘤低分化、内脏转移、转移时间<20个月、术后无局部放疗患者比率高于生存组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,原发肿瘤进展迅速、原发肿瘤低分化、内脏转移、转移时间<20个月、术后无局部放疗均是影响脊柱转移性肿瘤患者术后生存期的独立危险因素。结论 原发肿瘤进展迅速、原发肿瘤低分化、内脏转移、转移时间<20个月、术后无局部放疗均是影响脊柱转移性肿瘤患者术后生存期的独立危险因素,临床应加强对上述高危因素识别,并采取针对性预防措施。

Objective To analyze the influencing factors of postoperative survival in patients with spinal metastatic tumors.Methods 68 patients with spinal metastatic tumors were analyzed retrospectively.All patients underwent surgery.The patients were followed up for 2 years.The survival and death were counted and divided into death group and survival group.The general clinical data of patients were collected, and the influencing factors of postoperative survival of patients with spinal metastatic tumors were analyzed by univariate and multivariate logistic analysis.Results There was no significant difference in age, gender, smoking, body mass index(BMI),primary tumor, combined with basic diseases, the number of vertebral bodies involved and the amount of intraoperative bleeding(P>0.05);the rate of rapid progression of primary tumor, low differentiation of primary tumor, visceral metastasis, metastasis time < 20 months and no local radiotherapy in the death group was significantly higher than that in the survival group(P<0.05);multivariate logistic regression analysis showed that rapid progression of primary tumor, low differentiation of primary tumor, visceral metastasis, metastasis time < 20 months and no postoperative local radiotherapy were independent risk factors affecting the postoperative survival of patients with spinal metastatic tumor.Conclusion Rapid progression of primary tumor, low differentiation of primary tumor, visceral metastasis, metastasis time < 20 months and no postoperative local radiotherapy after surgery are independent risk factors affecting the postoperative survival of patients with spinal metastatic tumors.Clinically, we should strengthen the identification of the above high-risk factors and take targeted preventive measures.