The use of the Baumber scoring system for metastatic disease of the vertebral column

TL;DR

This study evaluates a patient-based prognostic scoring system for spinal metastases and finds it overestimates survival compared to actual outcomes.

Contribution

The study adapts and evaluates the Baumber scoring system for spinal metastases, revealing its limitations in this specific context.

Findings

The Baumber scoring system over-predicted survival by 39% at 6 months and 54% at 12 months for spinal metastases.

Parameters like hyponatraemia, hypoalbuminaemia, and low creatinine levels had greater influence on survival in spinal cases.

Differences in survival prediction may reflect variations in general health or cancer subtypes between spinal and appendicular groups.

Abstract

The prognostic assessment of metastatic spinal disease is predominantly tumour, rather than patient based. In 2021, Baumber et al. published a prognostic scoring system based on the patient as a whole rather than the tumour within the patient for metastatic disease of the appendicular skeleton. This paper assesses that prediction formula in those with metastatic disease of the spine.

Survival was recorded for 65 individuals who underwent surgery for spinal metastatic disease. Using the same parameters and hazard ratio as Baumber, the projected survival was longer than actually occurred (over-prediction of 39% at 6 months and 54% at 12 months). The relative contributions of the individual parameters as part of the overall survival was different between the groups with a greater contribution seen if the individual had hyponatraemia, hypoalbuminaemia and low levels of creatinine. The reasons for the differences seen between the spinal and appendicular groups with regards to these parameters are not clear but may represent a poorer level of general health or the behaviour of different types and subtypes of malignancy. Further work is required to develop a specific tool for the calculation of prognosis in a metastatic spinal cohort using a general health perspective.

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