Citations 1
Association Between Nutritional Status and Survival in Patients Requiring Treatment for Spinal Metastases
Versteeg, Anne L. , Charest-Morin, Raphaële, Ramos, Rafael De La Garza, Laufer, Ilya , Teixeira, William Gemio Jacobsen , Chou, Dean , Gokaslan, Ziya L. , Luzatti, Alessandro, Verlaan, Jorrit‐Jan , OʼToole, John E. , Sciubba, Daniel M. , Weber, Michael H. , Kawahara, Norio , Patel, Shalin S. , Disch, Alexander C. , Reynolds, Jeremy , Dea, Nicolas, Sahgal, Arjun , Rhines, Laurence D. , Fisher, Charles G., Tumor, on behalf of the AO Spine Knowledge Forum, Reynolds, Jeremy , Versteeg, Anne , Reynolds, Jeremy , Ramos, Rafael De la Garza , Barzilai, Ori , Gasbarrini, Alessandro , Fehlings, Michael G. , Netzer, Cordula , Goldschlager, Tony , Shin, John H. , Bettegowda, Chetan , Clarke, Michelle J. , Mesfin, Addisu , Goodwin, C. Rory , Lazáry, Áron , Boriani, Stefano , Dea, Nicolas , Fisher, Charles G., Tumor, on behalf of the AO Spine Knowledge Forum
Neurosurgery | November 6, 2025 | Volume: 99 | Issue: 2 | Pages: 345-353
BACKGROUND AND OBJECTIVES: The Patient-Generated Subjective Global Assessment (PG-SGA) is a standardized tool for assessing malnutrition in patients with cancer. The primary aim of this study was to assess the impact of preoperative nutritional status as measured by PG-SGA on survival in patients requiring surgical intervention and/or radiotherapy for spinal metastases. METHODS: Patients with spinal metastases who underwent surgery and/or radiation therapy for symptomatic spinal metastases were enrolled in the AO Spine Metastatic Tumor Research and Outcomes Network, a prospective international multicenter research registry, between September 2017 and August 2022. Using the PG-SGA, nutritional status was classified into 3 categories: A, well nourished; B, moderately malnourished; and C, severely malnourished. RESULTS: A total of 589 patients met the inclusion criteria; 362 were classified as well nourished (61%), 159 were moderately malnourished (27%), and 68 were severely malnourished (12%). The median survival was 491 days, 328 days, and 117 days for well-nourished, moderately malnourished, and severely malnourished patients, respectively. In the multivariate analyses, severe malnourishment (HR 2.5 95% CI 1.4-4.3, P < .01) and an ECOG performance status of 3 or 4 (HR 2.7 95% CI 1.2-6.0) remained associated with significantly worse survival. CONCLUSION: Malnutrition as measured by the PG-SGA demonstrated to be significantly and independently associated with postoperative survival. The PG-SGA is a simple and useful tool to identify spinal metastases patients at risk of early postoperative mortality, and inclusion in the preoperative evaluation of these patients should be considered.