Emeline Tabouret, G. Gravis, C. Cauvin, A. Loundou, T. Adetchessi, S. Fuentes


January 2015, Volume 24, Issue 1, pp 209 - 215 Original Article Read Full Article 10.1007/s00586-014-3676-1

First Online: 19 November 2014

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.


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