{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:05Z","timestamp":1787027765645,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mentors in Medicine Program, Division of Medical Education, Department of Internal Medicine, Washington University School of Medicine in St. Louis"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Spinal metastases are a significant cause of morbidity in patients with advanced cancer, and management often requires surgical intervention. Although prior studies have identified factors that influence outcomes with surgery, the ability of these factors to predict outcomes remains unclear in the era of contemporary therapies, and there is a need to better identify patients who are likely to benefit from surgery. Methods: We performed a single-center, retrospective analysis to evaluate risk factors for poor outcomes in patients with spinal metastases treated with surgery. The primary outcome was mortality at 180 days. Results: A total of 128 patients were identified. Age \u2265 65 years at surgery (p = 0.0316), presence of extraspinal metastases (p = 0.0110), and ECOG performance scores &gt;1 (p = 0.0397) were associated with mortality at 180 days on multivariate analysis. These factors and BMI \u2264 30 mg\/kg2 (p = 0.0008) were also associated with worse overall survival. Conclusions: Age &gt; 65, extraspinal metastases, and performance status scores &gt;1 are factors associated with mortality at 180 days in patients with spinal metastases treated with surgery. Patients with these factors and BMI \u2264 30 mg\/kg2 had worse overall survival. Our results support multidisciplinary discussions regarding the benefits and risks associated with surgery in patients with these risk factors.<\/jats:p>","DOI":"10.3390\/cancers16020438","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T07:00:32Z","timestamp":1705647632000},"page":"438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Outcomes in Patients with Spinal Metastases Managed with Surgical Intervention"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1953-9041","authenticated-orcid":false,"given":"Brendan","family":"Knapp","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Govindan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7934-7095","authenticated-orcid":false,"given":"Shalin S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kymberlie","family":"Pepin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningying","family":"Wu","sequence":"additional","affiliation":[{"name":"Biostatistics Shared Resource, Division of Public Health Sciences, Department of Surgery, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha","family":"Devarakonda","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Buchowski","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.spinee.2020.02.010","article-title":"Surgical treatment of metastatic spine disease: An update on national trends and clinical outcomes from 2010 to 2014","volume":"20","author":"Hsiue","year":"2020","journal-title":"Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jocn.2018.04.022","article-title":"Epidemiology and national trends in prevalence and surgical management of metastatic spinal disease","volume":"53","author":"Horn","year":"2018","journal-title":"J. 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