Frontiers in Surgery (Jan 2023)

Medium to long term follow-up of survival and quality of life in patients with primary tumors of the cervical spine: Experience From a large single center

  • Nanfang Xu,
  • Nanfang Xu,
  • Nanfang Xu,
  • Shuai Chang,
  • Shuai Chang,
  • Shuai Chang,
  • Xiaoguang Liu,
  • Xiaoguang Liu,
  • Xiaoguang Liu,
  • Liang Jiang,
  • Liang Jiang,
  • Liang Jiang,
  • Miao Yu,
  • Miao Yu,
  • Miao Yu,
  • Fengliang Wu,
  • Fengliang Wu,
  • Fengliang Wu,
  • Lei Dang,
  • Lei Dang,
  • Lei Dang,
  • Hua Zhou,
  • Hua Zhou,
  • Hua Zhou,
  • Yan Li,
  • Yan Li,
  • Yan Li,
  • Yongqiang Wang,
  • Yongqiang Wang,
  • Yongqiang Wang,
  • Xiao Liu,
  • Xiao Liu,
  • Xiao Liu,
  • Yunxia Wu,
  • Yunxia Wu,
  • Yunxia Wu,
  • Feng Wei,
  • Feng Wei,
  • Feng Wei,
  • Zhongjun Liu,
  • Zhongjun Liu,
  • Zhongjun Liu

DOI
https://doi.org/10.3389/fsurg.2022.1011100
Journal volume & issue
Vol. 9

Abstract

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ObjectivesTo evaluate the survival and medium to long term health-related quality of life (HRQoL) of patients with primary cervical spinal tumors in a cross-sectional study and to identify any significant associations with demographic or clinical characteristics.MethodsPatients diagnosed with primary cervical spinal tumors were retrospectively enrolled and their clinical, radiologic, and follow-up data (specifically the EQ-5D questionnaire) were collected. Univariate and multivariate Cox time-dependent regression analyses were performed to examine the significance of certain variables on overall survival. Univariate and multivariate logistic regression analyses were conducted to identify variables significant for overall HRQoL and each dimension of the EQ-5D.ResultsA total of 341 patients were enrolled in the study with a mean follow-up of 70 months. The diagnosis was benign in 246 cases, malignant in 84, and unconfirmed in 11. The 5-year overall survival rate was 86% and the 10-year overall survival rate was 65%. Multivariate analysis suggested that surgical treatment (P = 0.002, hazard ratio [HR] = 0.431, 95% CI. [0.254, 0.729]), benign and malignant tumors [P < 0.001, HR = 2.788, 95% CI. (1.721, 4.516)], tumor and surrounding normal tissue boundary [P = 0.010, HR = 1.950, 95% CI. (1.171, 3.249)], and spinal instability [P = 0.031, HR = 1.731, 95% CI. (1.051, 2.851)] still had significant effects on survival.ConclusionsIn this cross-sectional study, we evaluated the survival period and medium and long-term health-related quality of life of patients with primary tumors of the cervical spine, and analyzed the significant related factors of tumor clinical characteristics. Surgery, myelopathy, malignancy, spinal pain relieved by lying down or supine position, and tumor infiltration on MRI were significant predictors for overall survival. Enneking stage and age were significant predictors for HRQoL.

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