Survival Predictions in Spinal Metastasis: A Comparative Analysis of Modified Bauer and Van der Classification

Objective: The development of targeted therapies for primary tumors and early diagnosis enabled by advanced imaging methods have extended survival in cancer patients.This study aims to evaluate the effectiveness of the Modified Bauer and Van der Linden classifications in determining survival in the Turkish population.Methods: Retrospective analysis was conducted on 83 patients who presented with spinal metastases at neurosurgery clinic from 2012 to 2020.Demographic characteristics, malignancy origin, metastasis region, and scores Modified Bauer, Vander Linden systems were detailed.Survival was calculated from the date of diagnosis and analyzed using statistical software. Results:The average age of the 83 patients was 59.6 years; 67 (80.72%) were male, and 16 (19.27%)were female.Primary tumor types included lung cancer (43.37%), urogenital tumors (32.53%), gastrointestinal tumors (14.45%), breast tumors (7.22%), and nasopharyngeal tumors (2.4%).Thoracic involvement was present in 46.98%, lumbar in 39.75%, cervical in 8.43%, and sacral in 4.81%.In 45.78% of the patients, the diagnosis of a spinal mass led to further investigation to identify the primary tumor.The Modified Bauer score predicted survival accurately in 48.19% of patients, and the Van der Linden score in 46.99%.No significant difference was found between the tumor growth rate and the survival prediction accuracy of the classifications. Conclusion:While prognostic scoring systems provide useful guidance in managing spinal metastases, their predictive accuracy varies.These systems often underestimate survival predictions.Further improvements, including the development of new AI-assisted classifications, could enhance the accuracy of survival predictions and improve treatment strategies.