Estimating the Survival of Elderly Patients with Renal Cell Carcinoma Presenting with Malignant Spinal Cord Compression

Abstract

Aim: To develop a tool for predicting survival of elderly patients with malignant spinal cord compression (MSCC) from renal cell carcinoma.

Patients and methods: In 71 elderly patients, 10 factors were analyzed. Predictive scores were generated based on 6-month survival rates.

Results: Longer interval from renal cell carcinoma diagnosis to MSCC (p=0.019), lack of visceral metastases (p<0.001), slower progression of motor deficits (p<0.001), ambulation (p<0.001) and better performance status (p=0.002) were positive predictors. On multivariate analysis, interval from renal cell carcinoma diagnosis to MSCC (p=0.022), visceral metastases (p<0.001), time to developing motor dysfunction (p=0.041), gait function (p=0.002) and performance status (p=0.017) remained significant. Predictive scores were 17 to 36 points. Four groups were created: 17-23, 24-26, 27-29 and 30-36 points. Six-month survival rates were 8%, 30%, 69% and 100%, respectively (p<0.001).

Conclusion: This tool improves estimation of survival and personalized treatment options in elderly patients with MSCC from renal cell carcinoma.

Keywords: Renal cell carcinoma; elderly; malignant spinal cord compression; predictive tool; survival.