Erratum to: Preplanned safety analysis of the JFMC37-0801 trial: a randomized phase III study of six months versus twelve months of capecitabine as adjuvant chemotherapy for stage III colon cancer

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Editorial Board

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6





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Table of Contents

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6





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Table of Contents

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6





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Table of Contents

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6





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Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery!

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6
Author(s): A. Amelot, L. Balabaud, D. Choi, Z. Fox, H.A. Crockard, T. Albert, C.M. Arts, J.M. Buchowski, C. Bunger, C.K. Chung, M.H. Coppes, B. Depreitere, M.G. Fehlings, J. Harrop, N. Kawahara, E.S. Kim, C.S. Lee, Y. Leung, Z.J. Liu, J.A. Martin-Benlloch, E.M. Massicotte, B. Meyer, F.C. Oner, W. Peul, N. Quraishi, Y. Tokuhashi, K. Tomita, C. Ulbricht, J.J. Verlaan, M. Wang, C. Mazel
BackgroundWith recent advances in oncologic treatments, there has been an increase in patient survival rates and concurrently an increase in the number of incidence of symptomatic spinal metastases. Because elderly patients are a substantial part of the oncology population, their types of treatment as well as the possible impact their treatment will have on healthcare resources need to be further examined.PurposeWe studied whether age has a significant influence on quality of life and survival in surgical interventions for spinal metastases.Study DesignWe used data from a multicenter prospective study by the Global Spine Tumor Study Group (GSTSG). This GSTSG study involved 1,266 patients who were admitted for surgical treatments of symptomatic spinal metastases at 22 spinal centers from different countries and followed up for 2 years after surgery.Patient SampleThere were 1,266 patients recruited between March 2001 and October 2014.Outcome MeasuresPatient demographics were collected along with outcome measures, including European Quality of Life-5 Dimensions (EQ-5D), neurologic functions, complications, and survival rates.MethodsWe realized a multicenter prospective study of 1,266 patients admitted for surgical treatment of symptomatic spinal metastases. They were divided and studied into three different age groups: <70, 70–80, and >80 years.ResultsDespite a lack of statistical difference in American Society of Anesthesiologists (ASA) score, Frankel neurologic score, or Karnofsky functional score at presentation, patients >80 years were more likely to undergo emergency surgery and palliative procedures compared with younger patients. Postoperative complications were more common in the oldest age group (33.3% in the >80, 23.9% in the 70–80, and 17.9% for patients <70 years, p=.004). EQ-5D improved in all groups, but survival expectancy was significantly longer in patients <70 years old (p=.02). Furthermore, neurologic recovery after surgery was lower in patients >80 years old.ConclusionsSurgeons should not be biased against operating elderly patients. Although survival rates and neurologic improvements in the elderly patients are lower than for younger patients, operating the elderly is compounded by the fact that they undergo more emergency and palliative procedures, despite good ASA scores and functional status. Age in itself should not be a determinant of whether to operate or not, and operations should not be avoided in the elderly when indicated.



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Validation of the Spine Oncology Study Group—Outcomes Questionnaire to assess quality of life in patients with metastatic spine disease

Publication date: June 2017
Source:The Spine Journal, Volume 17, Issue 6
Author(s): Stein J. Janssen, Teun Teunis, Eva van Dijk, Marco L. Ferrone, John H. Shin, Francis Hornicek, Joseph H. Schwab
Background ContextGeneral questionnaires are often used to assess quality of life in patients with spine metastases, although a disease-specific survey did not exist until recently. The Spine Oncology Study Group has developed an outcomes questionnaire (SOSG-OQ) to measure quality of life in these patients. However, a scoring system was not developed, and the questionnaire was not validated in a group of patients, nor was it compared with other general quality of life questionnaires such as the EuroQol 5 Dimensions (EQ-5D) questionnaire.PurposeOur primary null hypothesis is that there is no association between the SOSG-OQ and EQ-5D. Our secondary null hypothesis is that there is no difference in coverage and internal consistency between the SOSG-OQ and EQ-5D. We also assess coverage, consistency, and validity of the domains within the SOSG-OQ.Study Design/SettingA survey study from a tertiary care spine referral center was used for this study.Patient SampleThe patient sample consisted of 82 patients with spine metastases, myeloma, or lymphoma.Outcome MeasuresThe SOSG-OQ (27 questions, 6 domains) score ranges from 0 to 80, with a higher score indicating worse quality of life. The EQ-5D (5 questions, 5 domains) index score ranges from 0 to 1, with a higher score indicating better quality of life.MethodsThe association between the SOSG-OQ and EQ-5D index score was assessed using the Spearman rank correlation. Instrument coverage and precision were assessed by determining item completion rate, median score with range, and floor and ceiling effect. Internal consistency was assessed using Cronbach alpha. Multitrait analysis and exploratory factor analysis were used to analyze properties of the individual domains in the SOSG-OQ.ResultsThe Spearman rank correlation between the SOSG-OQ and EQ-5D questionnaire was high (r=−0.83, p<.001). Internal consistency of the SOSG-OQ (0.92, 95% CI: 0.89–0.94) was higher as compared to the internal consistency of the EQ-5D (0.73, 95% CI: 0.63–0.84; p<.001). The SOSG-OQ score had no floor or ceiling effect indicating good coverage (median 30, range 3–64), whereas the EQ-5D had a ceiling effect of 10% (median 0.71, range 0.05–1).ConclusionsIn conclusion, our study proposes a scoring methodology—after reversing four inversely scored items—for the SOSG-OQ and shows that the questionnaire is a valid tool for the assessment of quality of life in patients with metastatic spine disease. The SOSG-OQ is superior to the EQ-5D in terms of coverage and internal consistency but consists of more questions.



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