A Tool to Estimate Survival of Elderly Patients Presenting with Metastatic Epidural Spinal Cord Compression (MESCC) from Cancer of Unknown Primary

Anticancer Res. 2015 Nov;35(11):6219-22.

Abstract

Aim: Cancers of unknown primary (CUP) account for about 10% in elderly patients with MESCC. Immediate treatment is indicated. Personalizing treatment for MESCC requires for clear understanding of the patients' survival prognosis. In this case, a tool for estimating survival would be valuable.

Patients and methods: In 104 elderly CUP patients, nine factors were investigated: age, gender, performance score, number of affected vertebrae, ability to walk at presentation for radiotherapy, additional bone metastases, visceral metastases, time developing motor weakness, radiotherapy program.

Results: In multivariate analysis, the ability to walk (p=0.011) and visceral metastases (p<0.001) were associated with survival. The following scores were assigned: unable to walk=0, able to walk=1, visceral metastases=0, no visceral metastases=1. Three groups were formed (0, 1 and 2 points) with 6-month survival rates of 7%, 18% and 73% (p<0.001).

Conclusion: This specific tool assists the physician to estimate survival and select for the most suitable radiotherapy program in elderly CUP patients with MESCC.

Keywords: Cancer of unknown primary; MESCC; elderly; radiation therapy; survival tool.

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Neoplasm Staging
  • Neoplasms, Unknown Primary / mortality*
  • Neoplasms, Unknown Primary / pathology
  • Neoplasms, Unknown Primary / radiotherapy
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Spinal Cord Compression / mortality*
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / radiotherapy
  • Spinal Neoplasms / mortality*
  • Spinal Neoplasms / radiotherapy
  • Spinal Neoplasms / secondary
  • Survival Rate