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Overall survival and prognostic factors in patients with spinal metastases from lung cancer treated with and without epidermal growth factor receptor tyrosine kinase inhibitors

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Abstract

Background

Evaluation of the prognosis in patients with spinal metastases is important in decision making regarding surgical treatment. The purpose of this study was to investigate overall survival in patients with spinal metastases from lung cancer by histological subtype, and to investigate prognostic factors in patients treated with and without epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).

Methods

The data from 135 patients diagnosed with spinal metastases from lung cancer were retrospectively evaluated. The 88 patients with adenocarcinoma were divided into two groups according to whether the lung cancer was treated with or without EGFR-TKIs—the EGFR-TKI group (n = 43) and the non-EGFR-TKI group (n = 45).

Results

The overall median survival time was 11.3 months for those with adenocarcinoma, 5.3 months for squamous cell carcinoma, and 3.9 months for small cell carcinoma. Overall survival in the EGFR-TKI group (median 21.4 months) was significantly longer than in the non-EGFR-TKI group (median 6.1 months). In univariate analysis, poor performance status was a poor prognostic factor in the non-EGFR-TKI group. However, performance status and other variables were not significant prognostic factors in the EGFR-TKI group.

Conclusions

Median overall survival was longer in patients with spinal metastases from lung cancer treated with EGFR-TKIs compared with those treated without EGFR-TKIs. Poor performance status or other prognostic factors were not associated with poor overall survival in the group treated with EGFR-TKIs.

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References

  1. Torre LA, Bray F, Siegel RL et al (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108. doi:10.3322/caac.21262

    Article  PubMed  Google Scholar 

  2. Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12(20 Pt 2):6243s–6249s. doi:10.1158/1078-0432.CCR-06-0931

    Article  PubMed  Google Scholar 

  3. Al Husaini H, Wheatley-Price P, Clemons M et al (2009) Prevention and management of bone metastases in lung cancer: a review. J Thorac Oncol 4(2):251–259. doi:10.1097/JTO.0b013e31819518fc

    Article  PubMed  Google Scholar 

  4. Brodowicz T, O’Byrne K, Manegold C (2012) Bone matters in lung cancer. Ann Oncol 23(9):2215–2222. doi:10.1093/annonc/mds009

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sugiura H, Yamada K, Sugiura T et al (2008) Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res 466(3):729–736. doi:10.1007/s11999-007-0051-0

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tang Y, Qu J, Wu J et al (2016) Effect of surgery on quality of life of patients with spinal metastasis from non-small-cell lung cancer. J Bone Joint Surg Am 98(5):396–402. doi:10.2106/JBJS.O.00629

    Article  PubMed  Google Scholar 

  7. Lee CK, Brown C, Gralla RJ et al (2013) Impact of EGFR inhibitor in non-small cell lung cancer on progression-free and overall survival: a meta-analysis. J Natl Cancer Inst 105(9):595–605. doi:10.1093/jnci/djt072

    Article  CAS  PubMed  Google Scholar 

  8. Tan JH, Tan KA, Zaw AS et al (2016) Evaluation of scoring systems and prognostic factors in patients with spinal metastases from lung cancer. Spine 41(7):638–644. doi:10.1097/BRS.0000000000001279

    Article  PubMed  Google Scholar 

  9. Katagiri H, Okada R, Takagi T et al (2014) New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med 3(5):1359–1367. doi:10.1002/cam4.292

    Article  PubMed  PubMed Central  Google Scholar 

  10. Fischer JE, Bachmann LM, Jaeschke R (2003) A readers’ guide to the interpretation of diagnostic test properties: clinical example of sepsis. Intensive Care Med 29(7):1043–1051. doi:10.1007/s00134-003-1761-8

    Article  PubMed  Google Scholar 

  11. Ettinger DS, Akerley W, Bepler G et al (2010) Non-small cell lung cancer. J Natl Compr Canc Netw 8(7):740–801

    Article  CAS  PubMed  Google Scholar 

  12. Azzoli CG, Temin S, Aliff T et al (2011) 2011 focused update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV non-small-cell lung cancer. J Clin Oncol 29(28):3825–3831. doi:10.1200/JCO.2010.34.2774

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rades D, Douglas S, Veninga T et al (2012) A validated survival score for patients with metastatic spinal cord compression from non-small cell lung cancer. BMC Cancer 12:302. doi:10.1186/1471-2407-12-302

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rades D, Weber A, Karstens JH et al (2014) Number of extraspinal organs with metastases: a prognostic factor of survival in patients with metastatic spinal cord compression (MSCC) from non-small cell lung cancer (NSCLC). Anticancer Res 34(5):2503–2507

    PubMed  Google Scholar 

  15. Ogihara S, Seichi A, Hozumi T et al (2006) Prognostic factors for patients with spinal metastases from lung cancer. Spine 31(14):1585–1590. doi:10.1097/01.brs.0000222146.91398.c9

    Article  PubMed  Google Scholar 

  16. Lee SM, Khan I, Upadhyay S et al (2012) First-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy (TOPICAL): a double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 13(11):1161–1170. doi:10.1016/S1470-2045(12)70412-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Inoue A, Kobayashi K, Usui K et al (2009) First-line gefitinib for patients with advanced non-small-cell lung cancer harboring epidermal growth factor receptor mutations without indication for chemotherapy. J Clin Oncol 27(9):1394–1400. doi:10.1200/JCO.2008.18.7658

    Article  CAS  PubMed  Google Scholar 

  18. Wang M, Bunger CE, Li H et al (2012) Predictive value of Tokuhashi scoring systems in spinal metastases, focusing on various primary tumor groups: evaluation of 448 patients in the Aarhus spinal metastases database. Spine 37(7):573–582. doi:10.1097/BRS.0b013e31822bd6b0

    Article  PubMed  Google Scholar 

  19. Hessler C, Vettorazzi E, Madert J et al (2011) Actual and predicted survival time of patients with spinal metastases of lung cancer: evaluation of the robustness of the Tokuhashi score. Spine 36(12):983–989. doi:10.1097/BRS.0b013e3181e8f7f8

    Article  PubMed  Google Scholar 

  20. Gregory TM, Coriat R, Mir O (2013) Prognostic scoring systems for spinal metastases in the era of anti-VEGF therapies. Spine 38(11):965–966. doi:10.1097/BRS.0b013e3182609d38

    Article  PubMed  Google Scholar 

  21. Ibrahim A, Crockard A, Antonietti P et al (2008) Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves March 2007. J Neurosurg Spine 8(3):271–278. doi:10.3171/SPI/2008/8/3/271

    Article  PubMed  Google Scholar 

  22. Patchell RA, Tibbs PA, Regine WF et al (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366(9486):643–648. doi:10.1016/S0140-6736(05)66954-1

    Article  PubMed  Google Scholar 

  23. Borghaei H, Paz-Ares L, Horn L et al (2015) Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. New Engl J Med 373(17):1627–1639. doi:10.1056/NEJMoa1507643

    Article  CAS  PubMed  Google Scholar 

  24. Brahmer J, Reckamp KL, Baas P et al (2015) Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. New Engl J Med 373(2):123–135. doi:10.1056/NEJMoa1504627

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima Higasiyodogawa-ku, Osaka, 533-0024, Japan

    Sho Dohzono, Ryuichi Sasaoka & Kiyohito Takamatsu

  2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Hiroaki Nakamura

Authors
  1. Sho Dohzono
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  2. Ryuichi Sasaoka
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  3. Kiyohito Takamatsu
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  4. Hiroaki Nakamura
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Correspondence to Sho Dohzono.

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The authors declare that they have no conflict of interest.

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Dohzono, S., Sasaoka, R., Takamatsu, K. et al. Overall survival and prognostic factors in patients with spinal metastases from lung cancer treated with and without epidermal growth factor receptor tyrosine kinase inhibitors . Int J Clin Oncol 22, 698–705 (2017). https://doi.org/10.1007/s10147-017-1116-z

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  • DOI: https://doi.org/10.1007/s10147-017-1116-z

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