QOLP-30. SURVIVAL, LOCAL CONTROL, AND HEALTH RELATED QUALITY OF LIFE IN OLIGOMETASTATIC AND POLYMETASTATIC SPINAL TUMORS: A MULTICENTER, INTERNATIONAL STUDY
Bibliographic record
Abstract
Oligometastatic disease (5 metastases) is considered an intermediate cancer state of limited metastatic capacity and improved prognosis. Hence, in recent years, treatment of oligometastatic spinal disease has trended towards more definitive, ablative therapies. Little is known about the actual prognosis of patients presenting with oligometastatic spinal disease. The focus of this study was to compare oligometastatic spine patients to those with polymetastatic disease (>5 metastases). This is an international, multicenter analysis of prospectively collected data. Data collected included demographics, survival, local control, histology, number and location of spine metastases, epidural spine cord compression (ESCC), the Spinal Instability Neoplastic Score (SINS), systemic disease burden, and treatment details. Health-related quality of life (HrQOL) measures included; numeric rating scale (NRS) for pain, EuroQol-5D (EQ-5D-3L), short form 36 version 2 (SF-36v2) and the spine oncology study group outcomes questionnaire (SOSGOQ). A total of 393 patients were included, of which 215 presented with oligometastatic disease and 178 with polymetastatic disease. A significant survival advantage was found for patients presenting with oligometastatic disease compared to those with polymetastatic disease at time of initial treatment of spinal metastases. This survival advantage was noticeable in both operative and non-operative patients. Local control rates were higher in the oligometastatic group for the spinal level treated. Furthermore, both groups experienced significant improvement in multiple HrQOL measures at 6 months post-treatment with no differences in these outcome measures between the two groups. At time of treatment of spinal metastatic disease, oligometastatic disease offers a significant survival advantage compared to polymetastatic disease, regardless of treatment choice. Local control can be achieved in both groups. HrQOL measures improve in both groups post-treatment, thus demonstrating a palliative treatment benefit for all treated patients. Our results support the oligometastatic theory and the current trend of ablative treatment for oligometastatic spine disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".