Prognostic factors affecting overall survival in patients with spinal metastasis due to lung cancer: a systematic review and meta-analysis.

Abstract

Metastatic lung cancer often spreads to the musculoskeletal structures and spinal column. Patients suffering from spinal metastasis due to lung cancer present poorer prognostic outcomes in terms of overall survival compared to spinal metastases from other origins. To date, no meta-analysis has attempted to evaluate the prognostic impact of various predictive factors that may influence the overall survival of patients with spinal metastasis due to metastatic lung cancer. The aim of the study was to evaluate the prognostic impact of different predictive factors that might influence the overall survival of patients with spinal metastasis due to metastatic lung cancer. Five electronic databases (Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE) were screened for eligible studies according to PRISMA guidelines. We conducted a random-effects meta-analysis to evaluate the prognostic impact of aging, pre-ambulatory status, radiotherapy, adenocarcinoma, performance status, visceral metastasis, and number of affected vertebrae on the overall survival of patients with spinal metastasis due to lung cancer. From 963 studies, we found 13 eligible studies with data on 1144 patients. Our meta-analysis revealed that pre-treatment ambulatory status (2.08), Eastern cooperative oncology group score (1.78), and aging (1.68) had significant impacts on overall survival. We provide preliminary evidence highlighting three factors potentially predictive of overall survival for patients suffering from spinal metastasis due to metastatic lung cancer. These findings may help clinicians stratify and manage patients more effectively.