Predicting postoperative quality-of-life outcomes in patients with metastatic spine disease: who benefits?

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  • Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Symptomatic spinal metastasis occurs in around 10% of all cancer patients, 5%–10% of whom will require operative management. While postoperative survival has been extensively evaluated, postoperative health-related quality-of-life (HRQOL) outcomes have remained relatively understudied. Available tools that measure HRQOL are heterogeneous and may emphasize different aspects of HRQOL. The authors of this paper recommend the use of the EQ-5D and Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ), given their extensive validation, to capture the QOL effects of systemic disease and spine metastases. Recent studies have identified preoperative QOL, baseline functional status, and neurological function as potential predictors of postoperative QOL outcomes, but heterogeneity across studies limits the ability to derive meaningful conclusions from the data. Future development of a valid and reliable prognostic model will likely require the application of a standardized protocol in the context of a multicenter study design.

ABBREVIATIONS AIS = American Spinal Injury Association Impairment Scale; ECOG = Eastern Cooperative Oncology Group; HRQOL = health-related QOL; KPS = Karnofsky Performance Scale; MDASI-SP = MD Anderson Symptom Inventory–Spine Tumor Module; ODI = Oswestry Disability Index; QOL = quality of life; SOSGOQ = Spine Oncology Study Group Outcomes Questionnaire.

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Contributor Notes

Correspondence Daniel M. Sciubba: Johns Hopkins University School of Medicine, Baltimore, MD. dsciubb1@jhmi.edu.

INCLUDE WHEN CITING Published online December 18, 2020; DOI: 10.3171/2020.7.SPINE201136.

Disclosures Mr. Cottrill has received an F30 grant from the National Institutes on Aging for a study unrelated to the study described. Dr. Sciubba is a consultant for Baxter, DePuy-Synthes, Globus Medical, K2M, Medtronic, NuVasive, and Stryker; has received grant support from Baxter Medical, North American Spine Society, and Stryker for a study unrelated to the study described; and is a member of the Spine Oncology Study Group.

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