Application of Morphometrics as a Predictor for Survival in Patients with Prostate Cancer Metastasis to the Spine.

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Application of Morphometrics as a Predictor for Survival in Patients with Prostate Cancer Metastasis to the Spine.

World Neurosurg. 2018 Mar 23;:

Authors: Zakaria HM, Massie L, Basheer A, Elibe E, Boyce-Fappiano D, Shultz L, Lee I, Griffith B, Siddiqui F, Chang V

Abstract
BACKGROUND: Surgery for spinal metastases can improve survival, but has high morbidity that can potentially diminish any benefit. New objective methods of predicting overall survival would be beneficial for surgical decision making. Morphometrics quantifies patient frailty and has been successfully used to predict overall survival in lung cancer patients with spine metastases. This study evaluates whether morphometrics can predict survival in patients with prostate cancer spinal metastases.
METHODS: Utilizing a retrospective registry of spinal metastases patients who have undergone stereotactic body radiation therapy, we identified patients with primary prostate cancer. Morphometric measurements of the psoas muscle were taken from the most recent lumbar spine CT. Patients were stratified into lowest, middle, and highest tertiles based on psoas muscle area. The primary outcome measure was overall survival from the date of CT scan.
RESULTS: A total of 92 patients were identified. The median survival for all patients was 124d (95%CI=98-197d). Patients in the smallest third for average psoas size had significantly shorter survival as compared to the largest third: 117d vs 302, HR 2.42 (95%CI=1.32-4.43), P=0.004. The shorter survival was also true for the middle third as compared to the largest third of psoas size: 113d vs 302, HR 2.31 (95%CI=1.25-4.25), P=0.007.
CONCLUSION: In prostate cancer patients with metastases to the spine, morphometric analysis of psoas muscle size can identify patients who are at risk for shorter survival. This simple technique can aid in surgical decision making by weighing expected survival and fitness versus the potential morbidity of intervention.

PMID: 29581018 [PubMed - as supplied by publisher]

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