Skip to main content

Advertisement

SpringerLink
Log in

SORG algorithm to predict 3- and 12-month survival in metastatic spinal disease: a cross-sectional population-based retrospective study

  • Original Article - Spine - Other
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Purpose

In this study, we wished to compare statistically the novel SORG algorithm in predicting survival in spine metastatic disease versus currently used methods.

Methods

We recruited 40 patients with spinal metastatic disease who were operated at Geneva University Hospitals by the Neurosurgery or Orthopedic teams between the years of 2015 and 2020. We did an ROC analysis in order to determine the accuracy of the SORG ML algorithm and nomogram versus the Tokuhashi original and revised scores.

Results

The analysis of data of our independent cohort shows a clear advantage in terms of predictive ability of the SORG ML algorithm and nomogram in comparison with the Tokuhashi scores. The SORG ML had an AUC of 0.87 for 90 days and 0.85 for 1 year. The SORG nomogram showed a predictive ability at 90 days and 1 year with AUCs of 0.87 and 0.76 respectively. These results showed excellent discriminative ability as compared with the Tokuhashi original score which achieved AUCs of 0.70 and 0.69 and the Tokuhashi revised score which had AUCs of 0.65 and 0.71 for 3 months and 1 year respectively.

Conclusion

The predictive ability of the SORG ML algorithm and nomogram was superior to currently used preoperative survival estimation scores for spinal metastatic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ahmed AK, Goodwin CR, Heravi A, Kim R, Abu-Bonsrah N, Sankey E, Kerekes D, De la Garza RR, Schwab J, Sciubba DM (2018) Predicting survival for metastatic spine disease: a comparison of nine scoring systems. Spine J 18(10):1804–1814. https://doi.org/10.1016/j.spinee.2018.03.011

    Article  PubMed  Google Scholar 

  2. Bollen L, van der Linden YM, Pondaag W, Fiocco M, Pattynama BP, Marijnen CA, Nelissen RG, Peul WC, Dijkstra PD (2014) Prognostic factors associated with survival in patients with symptomatic spinal bone metastases: a retrospective cohort study of 1,043 patients. Neuro Oncol 16(7):991–998. https://doi.org/10.1093/neuonc/not318

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bongers MER, Karhade AV, Villavieja J, Groot OQ, Bilsky MH, Laufer I, Schwab JH (2020) Does the SORG algorithm generalize to a contemporary cohort of patients with spinal metastases on external validation? Spine J. https://doi.org/10.1016/j.spinee.2020.05.003

    Article  PubMed  Google Scholar 

  4. Bouthors C, Prost S, Court C, Blondel B, Charles YP, Fuentes S, Mousselard HP, Mazel C, Flouzat-Lachaniette CH, Bonnevialle P, Saihlan F, the S (2020) Outcomes of surgical treatments of spinal metastases: a prospective study. Support Care Cancer 28(5):2127–2135. https://doi.org/10.1007/s00520-019-05015-5

    Article  CAS  PubMed  Google Scholar 

  5. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383. https://doi.org/10.1016/0021-9681(87)90171-8

    Article  CAS  PubMed  Google Scholar 

  6. Cole JS, Patchell RA (2008) Metastatic epidural spinal cord compression. Lancet Neurol 7(5):459–466. https://doi.org/10.1016/s1474-4422(08)70089-9

    Article  PubMed  Google Scholar 

  7. Collins GS, Reitsma JB, Altman DG, Moons KG (2015) Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD statement. Br J Surg 102(3):148–158. https://doi.org/10.1002/bjs.9736

    Article  CAS  PubMed  Google Scholar 

  8. Dea N, Versteeg AL, Sahgal A, Verlaan J-J, Charest-Morin R, Rhines LD, Sciubba DM, Schuster JM, Weber MH, Lazary A, Fehlings MG, Clarke MJ, Arnold PM, Boriani S, Bettegowda C, Laufer I, Gokaslan ZL, Fisher CG, Tumor obot AKF (2019) Metastatic spine disease: should patients with short life expectancy be denied surgical care? Int Retrospective Cohort Study Neurosurg 87(2):303–311. https://doi.org/10.1093/neuros/nyz472

    Article  Google Scholar 

  9. Forsberg JA, Wedin R, Bauer HC, Hansen BH, Laitinen M, Trovik CS, Keller JO, Boland PJ, Healey JH (2012) External validation of the Bayesian Estimated Tools for Survival (BETS) models in patients with surgically treated skeletal metastases. BMC Cancer 12:493. https://doi.org/10.1186/1471-2407-12-493

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gregory Zegarek, Enrico Tessitore, Aria Nouri, Karl Schaller, Renato Gondar. Sorg algorithm to predict 3- and 12-month survival in metastatic spinal disease: a cross-sectional population-based retrospective study. Brain and Spine. Volume 1, Supplement 1. 2021. 100122. ISSN 2772–5294. https://doi.org/10.1016/j.bas.2021.100122.

  11. Karhade AV, Thio Q, Ogink PT, Bono CM, Ferrone ML, Oh KS, Saylor PJ, Schoenfeld AJ, Shin JH, Harris MB, Schwab JH (2019) Predicting 90-day and 1-year mortality in spinal metastatic disease: development and internal validation. Neurosurgery 85(4):E671-e681. https://doi.org/10.1093/neuros/nyz070

    Article  PubMed  Google Scholar 

  12. Karhade AV, Ahmed AK, Pennington Z, Chara A, Schilling A, Thio Q, Ogink PT, Sciubba DM, Schwab JH (2020) External validation of the SORG 90-day and 1-year machine learning algorithms for survival in spinal metastatic disease. Spine J 20(1):14–21. https://doi.org/10.1016/j.spinee.2019.09.003

    Article  PubMed  Google Scholar 

  13. Katagiri H, Okada R, Takagi T, Takahashi M, Murata H, Harada H, Nishimura T, Asakura H, Ogawa H (2014) New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med 3(5):1359–1367

    Article  Google Scholar 

  14. Kirshblum S, Waring W 3rd (2014) Updates for the international standards for neurological classification of spinal cord injury. Phys Med Rehabil Clin N Am 25(3):505-517 vii. https://doi.org/10.1016/j.pmr.2014.04.001

    Article  PubMed  Google Scholar 

  15. Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, Bilsky MH (2013) The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist 18(6):744–751. https://doi.org/10.1634/theoncologist.2012-0293

    Article  PubMed  PubMed Central  Google Scholar 

  16. L’esperance S, Vincent F, Gaudreault M, Ouellet J, Li M, Tosikyan A, Goulet S, oncologieCdlédpe (2012) Treatment of metastatic spinal cord compression: CEPO review and clinical recommendations. Curr Oncol 19(6):e478

    Article  Google Scholar 

  17. Nater A, Tetreault LA, Kopjar B, Arnold PM, Dekutoski MB, Finkelstein JA, Fisher CG, France JC, Gokaslan ZL, Rhines LD, Rose PS, Sahgal A, Schuster JM, Vaccaro AR, Fehlings MG (2018) Predictive factors of survival in a surgical series of metastatic epidural spinal cord compression and complete external validation of 8 multivariate models of survival in a prospective North American multicenter study. Cancer 124(17):3536–3550. https://doi.org/10.1002/cncr.31585

    Article  PubMed  Google Scholar 

  18. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  Google Scholar 

  19. Paulino Pereira NR, Janssen SJ, van Dijk E, Harris MB, Hornicek FJ, Ferrone ML, Schwab JH (2016) Development of a prognostic survival algorithm for patients with metastatic spine disease. J Bone Joint Surg Am 98(21):1767–1776. https://doi.org/10.2106/jbjs.15.00975

    Article  PubMed  Google Scholar 

  20. Paulino Pereira NR, Janssen SJ, van Dijk E, Harris MB, Hornicek FJ, Ferrone ML, Schwab JH (2016) SORG nomogram application. https://sorg-apps.shinyapps.io/spinemetssurvival/. Accessed 26.09.2020 2020

  21. Paulino Pereira NR, McLaughlin L, Janssen SJ, van Dijk CN, Bramer JAM, Laufer I, Bilsky MH, Schwab JH (2017) The SORG nomogram accurately predicts 3- and 12-months survival for operable spine metastatic disease: external validation. J Surg Oncol 115(8):1019–1027. https://doi.org/10.1002/jso.24620

    Article  PubMed  Google Scholar 

  22. Sciubba DM, Petteys RJ, Dekutoski MB, Fisher CG, Fehlings MG, Ondra SL, Rhines LD, Gokaslan ZL (2010) Diagnosis and management of metastatic spine disease. A review J Neurosurg Spine 13(1):94–108. https://doi.org/10.3171/2010.3.Spine09202

    Article  PubMed  Google Scholar 

  23. Sciubba DM, Goodwin CR, Yurter A, Ju D, Gokaslan ZL, Fisher C, Rhines LD, Fehlings MG, Fourney DR, Mendel E, Laufer I, Bettegowda C, Patel SR, Rampersaud YR, Sahgal A, Reynolds J, Chou D, Weber MH, Clarke MJ (2016) A systematic review of clinical outcomes and prognostic factors for patients undergoing surgery for spinal metastases secondary to breast cancer. Global Spine J 6(5):482–496. https://doi.org/10.1055/s-0035-1564807

    Article  PubMed  Google Scholar 

  24. Taylor JW, Schiff D (2010) Metastatic epidural spinal cord compression. Semin Neurol 30(3):245–253. https://doi.org/10.1055/s-0030-1255221

    Article  PubMed  Google Scholar 

  25. Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 15(11):1110–1113. https://doi.org/10.1097/00007632-199011010-00005

    Article  CAS  Google Scholar 

  26. Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J (2005) A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 30(19):2186–2191. https://doi.org/10.1097/01.brs.0000180401.06919.a5

    Article  Google Scholar 

  27. Tokuhashi Y, Uei H, Oshima M, Ajiro Y (2014) Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop 5(3):262–271. https://doi.org/10.5312/wjo.v5.i3.262

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T (2001) Surgical strategy for spinal metastases. Spine (Phila Pa 1976) 26(3):298–306. https://doi.org/10.1097/00007632-200102010-00016

    Article  CAS  Google Scholar 

  29. Van Calster B, McLernon DJ, van Smeden M, Wynants L, Steyerberg EW, Topic Group “Evaluating diagnostic t, prediction models” of the Si (2019) Calibration: the Achilles heel of predictive analytics. BMC Med 17(1):230. https://doi.org/10.1186/s12916-019-1466-7

    Article  PubMed  PubMed Central  Google Scholar 

  30. van der Linden YM, Dijkstra SP, Vonk EJ, Marijnen CA, Leer JW (2005) Prediction of survival in patients with metastases in the spinal column: results based on a randomized trial of radiotherapy. Cancer 103(2):320–328. https://doi.org/10.1002/cncr.20756

    Article  PubMed  Google Scholar 

  31. Yang JJ, Chen CW, Fourman MS, Bongers MER, Karhade AV, Groot OQ, Lin WH, Yen HK, Huang PH, Yang SH, Schwab JH, Hu MH (2021) International external validation of the SORG machine learning algorithms for predicting 90-day and 1-year survival of patients with spine metastases using a Taiwanese cohort. Spine J S1529–9430(21):00060–7. https://doi.org/10.1016/j.spinee.2021.01.027

    Article  Google Scholar 

  32. Yoshihara H, Yoneoka D (2014) Trends in the surgical treatment for spinal metastasis and the in-hospital patient outcomes in the United States from 2000 to 2009. Spine J 14(9):1844–1849

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland

    Gregory Zegarek, Enrico Tessitore, Etienne Chaboudez, Aria Nouri, Karl Schaller & Renato Gondar

Authors
  1. Gregory Zegarek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enrico Tessitore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Etienne Chaboudez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aria Nouri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karl Schaller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Renato Gondar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory Zegarek.

Ethics declarations

Institutional review board statement

EMR review was given ethical approval by the Geneva University Hospitals institutional review board for retrospective chart analysis on patients who underwent surgery for spinal metastatic disease at our University tertiary care center.

Consent to participate

Informed consent for clinical research is systematically obtained from each patient after diagnosis and prior to surgery.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Spine—Other.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zegarek, G., Tessitore, E., Chaboudez, E. et al. SORG algorithm to predict 3- and 12-month survival in metastatic spinal disease: a cross-sectional population-based retrospective study. Acta Neurochir 164, 2627–2635 (2022). https://doi.org/10.1007/s00701-022-05322-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-022-05322-7

Keywords

Search

Navigation