{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:42:00Z","timestamp":1791042120668,"version":"4.1.0"},"reference-count":65,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T00:00:00Z","timestamp":1487721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0171507","type":"journal-article","created":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T13:43:00Z","timestamp":1487770980000},"page":"e0171507","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":46,"title":["Symptomatic spinal metastasis: A systematic literature review of the preoperative prognostic factors for survival, neurological, functional and quality of life in surgically treated patients and methodological recommendations for prognostic studies"],"prefix":"10.1371","volume":"12","author":[{"given":"Anick","family":"Nater","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan R.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Sahgal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-6364","authenticated-orcid":true,"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2017,2,22]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3171\/2010.3.SPINE09202","article-title":"Diagnosis and management of metastatic spine disease","volume":"13","author":"DM Sciubba","year":"2010","journal-title":"J Neurosurg Spine"},{"issue":"5","key":"ref2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1474-4422(08)70089-9","article-title":"Metastatic epidural spinal cord compression","volume":"7","author":"JS Cole","year":"2008","journal-title":"Lancet Neurol"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S1470-2045(05)70022-X","article-title":"Malignant spinal-cord compression","volume":"6","author":"D Prasad","year":"2005","journal-title":"Lancet Oncol"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3171\/2010.3.SPINE09202","article-title":"Diagnosis and management of metastatic spine disease. A review","volume":"13","author":"DM Sciubba","year":"2010","journal-title":"J Neurosurg Spine"},{"key":"ref5","unstructured":"National Cancer Institute. Cancer Statistics: U.S Department of Health and Human Services\u2014National Institutes of Health; Last updated: March 14, 2016 [March 18th, 2016]. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.cancer.gov\/about-cancer\/what-is-cancer\/statistics\" xlink:type=\"simple\">http:\/\/www.cancer.gov\/about-cancer\/what-is-cancer\/statistics<\/ext-link>."},{"issue":"9486","key":"ref6","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(05)66954-1","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"RA Patchell","year":"2005","journal-title":"Lancet"},{"issue":"6","key":"ref7","doi-asserted-by":"crossref","first-page":"e478","DOI":"10.3747\/co.19.1128","article-title":"Treatment of metastatic spinal cord compression: cepo review and clinical recommendations","volume":"19","author":"S L'Esperance","year":"2012","journal-title":"Curr Oncol"},{"key":"ref8","article-title":"Metastatic Spinal Cord Compression: Diagnosis and Management of Patients at Risk of or with Metastatic Spinal Cord Compression","year":"2008"},{"issue":"3","key":"ref9","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1200\/JCO.2015.61.9338","article-title":"Survival and Clinical Outcomes in Surgically Treated Patients With Metastatic Epidural Spinal Cord Compression: Results of the Prospective Multicenter AOSpine Study","volume":"34","author":"MG Fehlings","year":"2016","journal-title":"J Clin Oncol"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/(SICI)1097-0142(19990701)86:1<170::AID-CNCR23>3.0.CO;2-S","article-title":"The relative accuracy of the clinical estimation of the duration of life for patients with end of life cancer","volume":"86","author":"A Vigano","year":"1999","journal-title":"Cancer"},{"issue":"3","key":"ref11","first-page":"209","article-title":"How accurate are physicians&apos; clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review","volume":"13","author":"E Chow","year":"2001","journal-title":"Clin Oncol (R Coll Radiol)"},{"issue":"7","key":"ref12","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1634\/theoncologist.2009-0149","article-title":"How accurate are physicians in the prediction of patient survival in advanced lung cancer?","volume":"15","author":"C Clement-Duchene","year":"2010","journal-title":"Oncologist"},{"issue":"7","key":"ref13","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ejso.2011.02.009","article-title":"Clinical prediction of survival by surgeons for patients with incurable abdominal malignancy","volume":"37","author":"T Holmebakk","year":"2011","journal-title":"Eur J Surg Oncol"},{"issue":"5","key":"ref14","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/01.BRS.0000048646.26222.FA","article-title":"Quality of life in surgical treatment of metastatic spine disease","volume":"28","author":"EK Wai","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"issue":"24","key":"ref15","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.1097\/01.brs.0000245838.37817.40","article-title":"Impact of surgical intervention on quality of life in patients with spinal metastases","volume":"31","author":"A Falicov","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"ref16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s00586-004-0870-6","article-title":"Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases","volume":"15","author":"KA Jansson","year":"2006","journal-title":"Eur Spine J"},{"issue":"3","key":"ref17","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3171\/SPI\/2008\/8\/3\/271","article-title":"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","volume":"8","author":"A Ibrahim","year":"2008","journal-title":"J Neurosurg Spine"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.spinee.2009.06.016","article-title":"The value of palliative surgery for metastatic spinal disease: satisfaction of patients and their families","volume":"10","author":"S Fujibayashi","year":"2010","journal-title":"Spine J"},{"issue":"5","key":"ref19","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s00432-010-0946-0","article-title":"Survival prognostic factors and clinical outcomes in patients with spinal metastases","volume":"137","author":"V Pointillart","year":"2011","journal-title":"J Cancer Res Clin Oncol"},{"issue":"11","key":"ref20","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1007\/s00586-011-1867-6","article-title":"Surgery improves pain, function and quality of life in patients with spinal metastases: a prospective study on 118 patients","volume":"20","author":"GM Quan","year":"2011","journal-title":"Eur Spine J"},{"issue":"2","key":"ref21","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s40273-013-0121-y","article-title":"The economic burden of skeletal-related events among elderly men with metastatic prostate cancer","volume":"32","author":"J Jayasekera","year":"2014","journal-title":"Pharmacoeconomics"},{"issue":"2","key":"ref22","doi-asserted-by":"crossref","first-page":"e1001381","DOI":"10.1371\/journal.pmed.1001381","article-title":"Prognosis Research Strategy (PROGRESS) 3: prognostic model research","volume":"10","author":"EW Steyerberg","year":"2013","journal-title":"PLoS Med"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"b375","DOI":"10.1136\/bmj.b375","article-title":"Prognosis and prognostic research: what, why, and how?","volume":"338","author":"KG Moons","year":"2009","journal-title":"BMJ"},{"issue":"11","key":"ref24","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/s00586-008-0763-1","article-title":"Predictive value of seven preoperative prognostic scoring systems for spinal metastases","volume":"17","author":"A Leithner","year":"2008","journal-title":"Eur Spine J"},{"issue":"3","key":"ref25","doi-asserted-by":"crossref","first-page":"E155","DOI":"10.1097\/BRS.0000000000001192","article-title":"Predictive Value of Six Prognostic Scoring Systems for Spinal Bone Metastases: An Analysis Based on 1379 Patients","volume":"41","author":"L Bollen","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"issue":"23","key":"ref26","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1097\/BRS.0b013e3182011f84","article-title":"Survival analysis of 254 patients after manifestation of spinal metastases: evaluation of seven preoperative scoring systems","volume":"36","author":"C Wibmer","year":"2011","journal-title":"Spine"},{"issue":"9","key":"ref27","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1002\/cncr.23002","article-title":"Development of a model with which to predict the life expectancy of patients with spinal epidural metastasis","volume":"110","author":"RH Bartels","year":"2007","journal-title":"Cancer"},{"issue":"1","key":"ref28","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1093\/neuonc\/nov149","article-title":"Prediction of life expectancy in patients with spinal epidural metastasis","volume":"18","author":"RH Bartels","year":"2016","journal-title":"Neuro Oncol"},{"issue":"7","key":"ref29","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"D Moher","year":"2009","journal-title":"PLoS Med"},{"key":"ref30","unstructured":"PROSPERO\u2014International Prospective Register of Systematic Reviews. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.crd.york.ac.uk\/PROSPERO\/\" xlink:type=\"simple\">http:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/ext-link>."},{"key":"ref31","unstructured":"R.R. Bowker Company, and Serials Solutions. Ulrichsweb: Global Serials Directory New Providence; NJ: R.R. Bowker; 2016 [January 21st, 2016]. <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/ulrichsweb.serialssolutions.com\" xlink:type=\"simple\">http:\/\/ulrichsweb.serialssolutions.com<\/ext-link>."},{"issue":"22 Suppl 1","key":"ref32","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1097\/BRS.0b013e3182a7ebbf","article-title":"Cervical spondylotic myelopathy: methodological approaches to evaluate the literature and establish best evidence","volume":"38","author":"AC Skelly","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref33","article-title":"Methodology Checklist and Risk of Bias Definitions for Prognostic Studies: Spectrum Research Standard Operating Procedures for Systematic Review","author":"JR Dettori","year":"2013"},{"issue":"4","key":"ref34","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE guidelines: 3. Rating the quality of evidence","volume":"64","author":"H Balshem","year":"2011","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"ref35","doi-asserted-by":"crossref","first-page":"427","DOI":"10.7326\/0003-4819-144-6-200603210-00010","article-title":"Evaluation of the quality of prognosis studies in systematic reviews","volume":"144","author":"JA Hayden","year":"2006","journal-title":"Ann Intern Med"},{"issue":"5","key":"ref36","doi-asserted-by":"crossref","first-page":"564","DOI":"10.3171\/spi.2005.2.5.0564","article-title":"Surgical management of spinal metastases: analysis of prognostic factors during a 10-year experience","volume":"2","author":"RB North","year":"2005","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"ref37","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1227\/01.neu.0000317317.33365.15","article-title":"Predictors of ambulatory function after decompressive surgery for metastatic epidural spinal cord compression","volume":"62","author":"KL Chaichana","year":"2008","journal-title":"Neurosurgery"},{"issue":"11","key":"ref38","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.spinee.2011.09.007","article-title":"Resumption of ambulatory status after surgery for nonambulatory patients with epidural spinal metastasis","volume":"11","author":"CH Kim","year":"2011","journal-title":"Spine J"},{"issue":"3","key":"ref39","first-page":"216","article-title":"Postoperative survival and ambulatory outcome in metastatic spinal tumors: prognostic factor analysis","volume":"50","author":"KY Moon","year":"2011","journal-title":"J"},{"issue":"5","key":"ref40","first-page":"434","article-title":"Efficacy of decompression and fixation for metastatic spinal cord compression: analysis of factors prognostic for survival and postoperative ambulation","volume":"50","author":"JH Park","year":"2011","journal-title":"J"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1186\/s12885-015-1852-2","article-title":"Prediction of survival prognosis after surgery in patients with symptomatic metastatic spinal cord compression from non-small cell lung cancer","volume":"15","author":"M Lei","year":"2015","journal-title":"BMC Cancer"},{"issue":"5","key":"ref42","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1227\/NEU.0000000000000907","article-title":"Prediction of Quality of Life and Survival After Surgery for Symptomatic Spinal Metastases: A Multicenter Cohort Study to Determine Suitability for Surgical Treatment","volume":"77","author":"D Choi","year":"2015","journal-title":"Neurosurgery"},{"issue":"7","key":"ref43","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1302\/0301-620X.85B7.14201","article-title":"A population-based study of surgery for spinal metastases. Survival rates and complications","volume":"85","author":"JA Finkelstein","year":"2003","journal-title":"J Bone Joint Surg Br"},{"issue":"436","key":"ref44","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/01.blo.0000160003.70673.2a","article-title":"Prognostic relevance of clinical symptoms in patients with spinal metastases","author":"N Hosono","year":"2005","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"ref45","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1007\/s00586-014-3268-0","article-title":"The outcome and survival of palliative surgery in thoraco-lumbar spinal metastases: contemporary retrospective cohort study","volume":"23","author":"RM Nemelc","year":"2014","journal-title":"Eur Spine J"},{"issue":"2","key":"ref46","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1007\/s11999-012-2699-3","article-title":"Is surgery for spine metastasis reasonable in patients older than 60 years?","volume":"471","author":"T Liang","year":"2013","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"ref47","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3171\/2011.9.SPINE11422","article-title":"Surgical management of unknown primary tumors metastatic to the spine","volume":"16","author":"MR Aizenberg","year":"2012","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"ref48","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1227\/NEU.0b013e31820773b2","article-title":"Trends in survival after surgery for breast cancer metastatic to the brain and spinal column in medicare patients: a population-based analysis","volume":"68","author":"KS Cahill","year":"2011","journal-title":"Neurosurgery"},{"issue":"5","key":"ref49","doi-asserted-by":"crossref","first-page":"414","DOI":"10.3171\/2009.1.SPINE08509","article-title":"Surgical management of prostate cancer metastatic to the spine","volume":"10","author":"BJ Williams","year":"2009","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"ref50","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1227\/NEU.0b013e318207780c","article-title":"Predictors of survival after surgical treatment of spinal metastasis","volume":"68","author":"RT Arrigo","year":"2011","journal-title":"Neurosurgery"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/s13018-015-0291-8","article-title":"Preoperative palsy score has no significant association with survival in non-small-cell lung cancer patients with spinal metastases who undergo spinal surgery","volume":"10","author":"YJ Chen","year":"2015","journal-title":"J Orthop Surg Res"},{"issue":"23","key":"ref52","doi-asserted-by":"crossref","first-page":"E1339","DOI":"10.1097\/BRS.0b013e3181e574f5","article-title":"Preoperative scoring systems and prognostic factors for patients with spinal metastases from hepatocellular carcinoma","volume":"35","author":"H Chen","year":"2010","journal-title":"Spine"},{"issue":"3","key":"ref53","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/00007632-200102010-00016","article-title":"Surgical strategy for spinal metastases","volume":"26","author":"K Tomita","year":"2001","journal-title":"Spine (Phila Pa 1976)"},{"issue":"26","key":"ref54","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1097\/BRS.0b013e31826011bc","article-title":"Predicting survival for surgery of metastatic spinal cord compression in prostate cancer: a new score","volume":"37","author":"S Crnalic","year":"2012","journal-title":"Spine"},{"key":"ref55","article-title":"A validated preoperative score predicting survival and functional outcome in lung cancer patients operated with posterior decompression and stabilization for metastatic spinal cord compression","author":"M Lei","year":"2015","journal-title":"Eur Spine J"},{"issue":"9","key":"ref56","first-page":"1183","article-title":"Is Tokuhashi score suitable for evaluation of life expectancy before surgery in Iranian patients with spinal metastases?","volume":"16","author":"R Mollahoseini","year":"2011","journal-title":"J Res Med Sci"},{"issue":"6","key":"ref57","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1007\/s00586-013-2726-4","article-title":"Risk factors for survival of 106 surgically treated patients with symptomatic spinal epidural metastases","volume":"22","author":"L Bollen","year":"2013","journal-title":"Eur Spine J"},{"issue":"5","key":"ref58","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"ME Charlson","year":"1987","journal-title":"J Chronic Dis"},{"issue":"3","key":"ref59","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/00007632-200102010-00016","article-title":"Surgical strategy for spinal metastases","volume":"26","author":"K Tomita","year":"2001","journal-title":"Spine"},{"issue":"9","key":"ref60","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1097\/00003246-199809000-00036","article-title":"Understanding articles describing clinical prediction tools. Evidence Based Medicine in Critical Care Group","volume":"26","author":"AG Randolph","year":"1998","journal-title":"Crit Care Med"},{"issue":"2","key":"ref61","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1038\/sj.bjc.6601118","article-title":"Survival analysis part I: basic concepts and first analyses","volume":"89","author":"TG Clark","year":"2003","journal-title":"Br J Cancer"},{"issue":"3","key":"ref62","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1038\/sj.bjc.6601119","article-title":"Survival analysis part II: multivariate data analysis\u2014an introduction to concepts and methods","volume":"89","author":"MJ Bradburn","year":"2003","journal-title":"Br J Cancer"},{"issue":"7306","key":"ref63","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1136\/bmj.323.7306.224","article-title":"Systematic reviews of evaluations of prognostic variables","volume":"323","author":"DG Altman","year":"2001","journal-title":"Bmj"},{"key":"ref64","first-page":"184","article-title":"Prognostic factors. Confusion caused by bad quality design, analysis and reporting of many studies","volume":"62","author":"W Sauerbrei","year":"2005","journal-title":"Adv Otorhinolaryngol"},{"issue":"4","key":"ref65","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1175\/1520-0469(1969)26<636:APARBN>2.0.CO;2","article-title":"Atmospheric predictability as revealed by naturally occurring analogues","volume":"24","author":"EN Lorenz","year":"1969","journal-title":"Journal of the Atmospheric Sciences"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0171507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T20:06:43Z","timestamp":1568837203000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0171507"}},"subtitle":[],"editor":[{"given":"Shian-Ying","family":"Sung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2017,2,22]]},"references-count":65,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,2,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0171507","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,22]]}}}