Health-related quality of life in patients with spinal metastases treated with or without spinal surgery: a prospective, longitudinal study.

Background: The objective of this study was to determine whether surgery for patients with spinal metastases could improve the quality of remaining life and prolong survival.

Methods: In total, 96 patients who had spinal metastases were recruited from Changzheng Hospital at the Second Military Medical University in Shanghai, China, over the period from July 2007 to June 2009. The patients received treatments with or without spinal surgery (surgery group, n=46 patients; nonsurgery group, n=50 patients), and all patients received adjuvant therapies according to their original cancer and individual conditions. Patients' quality of life (QOL) was assessed at 5 time points-at the initial diagnosis (baseline) and at 1 month, 3 months, 6 months, and 9 months of follow-up-using the Functional Assessment of Cancer Therapy-General QOL questionnaire. Information on survival also was collected.

Results: Sixty-seven of 96 patients completed all 5 follow-up assessments, including 33 patients in the surgery group and 34 patients in the nonsurgery group. The other 29 patients died within 9 months after the initial diagnosis. At the end of the study (June 2009), 22 patients (47.8%) remained alive in the surgery group, and with 16 patients (32%) remained alive in the nonsurgery group. The surgery group had significantly higher total QOL scores, physical well being scores, emotional well being scores, and functional well being scores than the nonsurgery group over the 9-month assessment period. There was no statistically significant difference in survival between the 2 groups (P=.056).

Conclusions: The current results indicated that surgical treatment greatly improved and maintained the QOL of patients who had spinal metastases over the 9-month assessment period and that surgery is an effective treatment for spinal metastases.