Long-term survivors after surgical management of metastatic spinal cord compression

Eur Spine J. 2015 Jan;24(1):209-15. doi: 10.1007/s00586-014-3676-1. Epub 2014 Nov 19.

Abstract

Purpose: Metastatic spinal cord compression (MSCC) incidences are increasing. Our objective was to identify predictive factors involved in long-term survival after use of a surgical approach.

Methods: We retrospectively analyzed all patients referred to our institution for MSCC who underwent surgery (N = 138). We identified patients with an overall survival (OS) rate greater than 2 years, compared their characteristics to the remaining patients, and performed recursive partitioning analysis (RPA).

Results: Median OS was 7.8 months (95 % confidence interval 4.4-11.2). Thirty-nine patients presented with OS ≥2 years. A comparative analysis found significant differences concerning the delay (first symptom-surgery, p < 0.001), number of systemic (p = 0.001) or bone metastases (p = 0.013), Karnofsky performance status (KPS) (p = 0.006), Frankel (p = 0.025), ASA scores (p < 0.001), weight loss (p = 0.003), hyperalgia (p = 0.002), chemotherapy use (p = 0.034), and primary tumor (p < 0.001). RPA classification identified six prognostic classes based on the ASA score, primary type, KPS, and systemic metastases.

Conclusion: Long-term metastatic cancer survivor patients are an increasing population with specific characteristics.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Bone Neoplasms / secondary
  • Female
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery*
  • Spinal Neoplasms / mortality*
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / surgery*
  • Time-to-Treatment
  • Weight Loss
  • Young Adult

Substances

  • Antineoplastic Agents