Table 4.
Prognostic Factor Analysis for Overall Survival of the Validation Group
| Univariate analysis | Multivariate analysis | ||||||
|---|---|---|---|---|---|---|---|
|
|
|
||||||
| No. of patients | MS, mo | p-value* | Coefficient | HR | 95% CI | p-value† | |
| Age, yr | 0.058 | - | - | - | - | ||
| ≤55 | 20 | 3.4 | |||||
| >55 | 43 | 5.8 | |||||
| Gender | 0.567 | - | - | - | - | ||
| Male | 59 | 4.8 | |||||
| Female | 4 | 2.0 | |||||
| ECOG performance status | <0.001 | 2.584 | 13.244 | 4.606–38.079 | <0.001 | ||
| 0–2 | 56 | 5.8 | |||||
| 3–4 | 7 | 1.4 | |||||
| AFP, ng/mL | <0.001 | 1.284 | 3.613 | 1.873–6.967 | <0.001 | ||
| ≤200 | 32 | 9.8 | |||||
| >200 | 31 | 3.0 | |||||
| Child-Pugh classification | <0.001 | 2.868 | 17.610 | 5.262–58.933 | <0.001 | ||
| A, B | 58 | 4.8 | |||||
| C | 5 | 0.4 | |||||
| Primary HCC | 0.004 | 1.054 | 2.869 | 1.425–5.778 | 0.003 | ||
| Controlled | 22 | 9.0 | |||||
| Uncontrolled | 41 | 3.4 | |||||
| Interval from diagnosis of primary tumor to spinal metastases, mo | 0.692 | - | - | - | - | ||
| ≤12 | 28 | 3.7 | |||||
| >12 | 35 | 5.8 | |||||
| Baseline BPI score (pain severity) | 0.887 | - | - | - | - | ||
| ≤6 | 40 | 4.8 | |||||
| >6 | 20 | 4.5 | |||||
| Extrahepatic metastases other than bone | <0.001 | 1.213 | 3.362 | 1.676–6.743 | 0.001 | ||
| Yes | 39 | 2.7 | |||||
| No | 24 | 9.8 | |||||
| Site of spinal metastasis | 0.051 | - | - | - | - | ||
| Cervical | 2 | 10.5 | |||||
| Thoracic | 13 | 6.4 | |||||
| Lumbar | 6 | 7.3 | |||||
| Sacrum | 4 | 13.8 | |||||
| Combined (2 sites or more) | 38 | 3.7 | |||||
| Multiplicity of spinal metastases | 0.013 | 0.635 | 1.887 | 0.976–3.648 | 0.059 | ||
| Yes | 41 | 3.7 | |||||
| No | 22 | 8.9 | |||||
| Mass-type metastases | 0.200 | - | - | - | - | ||
| Yes | 29 | 3.7 | |||||
| No | 34 | 5.8 | |||||
| Spinal cord compression (ASIA scale A–C) | 0.025 | −0.072 | 0.930 | 0.424–2.040 | 0.857 | ||
| Yes (A–C) | 17 | 3.4 | |||||
| No (D, E) | 46 | 5.8 | |||||
| Pathologic fracture | 0.301 | - | - | - | - | ||
| Yes | 22 | 3.4 | |||||
| No | 41 | 5.2 | |||||
| BED, Gy10 | 0.010 | −0.038 | 0.963 | 0.398–2.329 | 0.932 | ||
| ≤38 | 29 | 3.0 | |||||
| 39–53 | 23 | 7.6 | |||||
| >53 | 11 | 8.9 | |||||
| Treatment modalities | 0.228 | - | - | - | - | ||
| RT alone | 24 | 5.8 | |||||
| RT+CTx | 27 | 3.7 | |||||
| RT+S±CTx | 12 | 8.9 | |||||
| RT technique | 0.913 | - | - | - | - | ||
| 3D-CRT or conventional 2D | 39 | 4.5 | |||||
| IMRT or tomotherapy | 24 | 4.8 | |||||
| Pain response | 0.209 | - | - | - | - | ||
| CR | 13 | 8.8 | |||||
| Non-CR | 47 | 4.3 | |||||
MS, median survival; 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; 3D-CRT, 3-dimensional conformal radiation therapy; 2D, 2-dimensional; IMRT, intensity-modulated radiation therapy; CR, complete pain response.
*
Determined using the log-rank test;
†
Determined using the Cox proportional hazard model.