Surgical management of spinal metastases from primary lung carcinoma: demographics, clinical characteristics, and outcomes—A retrospective analysis

Objective: This study aims to evaluate the efficacy of palliative surgery in patients with spinal metastases from lung cancer and to identify prognostic factors affecting postoperative 1-year survival, providing clinical treatment references for these patients. Methods: Clinical data of 55 patients with spinal metastases from lung cancer who underwent surgery at Shenzhen People's Hospital from January 2017 to December 2022 were analyzed. Improvements in preoperative and postoperative visual pain scores, ODI scores, and Frankel grades were assessed. Kaplan-Meier method was used to plot survival curves, and the Cox proportional hazards model was employed to analyze various factors influencing postoperative 1-year survival. Results: Surgical treatment helped alleviate pain, maintain or improve neurological function, and enhance the quality of life. Among the 55 patients, 23 (41.82%) died, and 32 (58.18%) survived, with a median survival time of 16.83 months (95% CI: 9.88, 23.78) and a one-year survival rate of 58.18%.Factors influencing postoperative 1-year survival included ODI score one-month post-surgery, presence of visceral metastases, and postoperative bone modifying agents (BMA). Multivariate Cox proportional hazards model survival analysis indicated that the presence of visceral metastases and postoperative BMA were independent factors affecting one-year survival in these patients. Conclusion: Surgical treatment effectively alleviates pain, maintains or improves neurological function, and enhances the quality of life in patients with spinal metastases from lung cancer. The presence of visceral metastases and postoperative BMA are independent factors influencing postoperative 1-year survival.