Table 4.
Univariate and Multivariate Analyses to Identify Predictive Factors for Overall Survival
| Variable | Univariate analysis | Multivariate analysis | |||||
|---|---|---|---|---|---|---|---|
|
|
|
||||||
| No. of patients | Median survival±SE, mo | p-value* | Coefficient | HR | 95% CI | p-value† | |
| Age, yr | 0.492 | ||||||
| ≤55 | 86 | 4.8±0.5 | |||||
| >55 | 106 | 3.9±0.5 | |||||
| Gender | 0.430 | ||||||
| Male | 157 | 4.5±0.3 | |||||
| Female | 35 | 5.3±1.7 | |||||
| ECOG performance status | <0.001 | 0.639 | 1.895 | 1.302–2.757 | 0.001 | ||
| 0–2 | 104 | 5.7±0.3 | |||||
| 3–4 | 88 | 2.7±0.3 | |||||
| AFP, ng/mL | 0.143 | ||||||
| ≤200 | 98 | 4.7±0.5 | |||||
| >200 | 94 | 2.8±0.6 | |||||
| Child-Pugh classification | 0.025 | 0.259 | 1.165 | 0.693–1.755 | 0.164 | ||
| A, B | 172 | 4.5±0.4 | |||||
| C | 20 | 2.0±1.2 | |||||
| Primary HCC | <0.001 | 1.279 | 3.595 | 2.453–5.268 | <0.001 | ||
| Controlled | 127 | 6.2±0.5 | |||||
| Uncontrolled | 65 | 1.9±0.3 | |||||
| Interval from diagnosis of primary tumor to spinal metastases, mo | 0.966 | ||||||
| ≤9 | 100 | 4.2±0.5 | |||||
| >9 | 92 | 4.0±0.7 | |||||
| Baseline BPI score (pain severity) | 0.857 | ||||||
| ≤6 | 114 | 4.8±0.6 | |||||
| >6 | 78 | 4.2±0.5 | |||||
| Extrahepatic metastases other than bone | 0.012 | −0.560 | 0.571 | 0.391–0.835 | 0.004 | ||
| Yes | 50 | 2.8±0.6 | |||||
| No | 142 | 5.0±0.5 | |||||
| Sites of spinal metastases | 0.169 | ||||||
| Cervical | 26 | 2.5±1.3 | |||||
| Thoracic | 46 | 4.8±0.4 | |||||
| Lumbar | 48 | 5.7±1.4 | |||||
| Sacrum | 8 | 4.5±2.8 | |||||
| Combined (2 sites or more) | 64 | 3.7±0.6 | |||||
| Multiplicity of spinal metastases | 0.112 | ||||||
| Yes | 105 | 5.0±0.5 | |||||
| No | 87 | 3.9±0.7 | |||||
| Mass-type metastases | 0.577 | ||||||
| Yes | 46 | 4.7±1.7 | |||||
| No | 146 | 4.5±0.4 | |||||
| Spinal cord compression (ASIA scale A–C) | 0.839 | ||||||
| Yes (A–C) | 25 | 4.0±2.0 | |||||
| No (D–E) | 167 | 4.5±0.4 | |||||
| Pathologic fracture | 0.003 | −0.342 | 0.710 | 0.476–1.059 | 0.093 | ||
| Yes | 47 | 2.7±0.5 | |||||
| No | 145 | 5.0±0.3 | |||||
| BED, Gy10 | <0.001 | −0.624 | 0.536 | 0.383–0.751 | <0.001 | ||
| ≤38 | 38 | 2.4±0.6 | |||||
| 39–53 | 132 | 9.7±1.6 | |||||
| >53 | 22 | 15.2±4.2 | |||||
| Treatment modalities | 0.926 | ||||||
| RT alone | 140 | 3.9±0.6 | |||||
| RT+CTx | 38 | 4.0±1.3 | |||||
| RT+S±CTx | 14 | 5.3±0.6 | |||||
| RT technique | 0.110 | ||||||
| Conventional (2D) | 107 | 3.9±0.6 | |||||
| 3D-CRT or IMRT | 85 | 4.5±0.7 | |||||
| Pain response | 0.001 | 0.308 | 1.361 | 0.938–1.973 | 0.104 | ||
| CR | 41 | 7.2±1.8 | |||||
| Non-CR | 151 | 3.0±0.4 | |||||
SE, standard error; HR, hazard ratio; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; AFP, α-fetoprotein; HCC, hepatocellular carcinoma; BPI, Brief Pain Inventory; ASIA, American Spinal Injury Association; BED, biologically effective dose; RT, radiotherapy; CTx, chemotherapy; S, surgery; 2D, 2-dimensional; 3D-CRT, 3-dimensional conformal radiation therapy; IMRT, intensity-modulated radiation therapy; CR, complete pain response.
*
Determined using the log-rank test;
†
Determined using the Cox proportional hazard model.