A score to identify patients with metastatic spinal cord compression who may be candidates for best supportive care

Abstract

BACKGROUND:The objective of the current study was to develop a scoring system that identifies those patients with metastatic spinal cord compression who may be candidates for best supportive care or single-fraction radiotherapy. METHODS: Ten potential prognostic factors were retrospectively analyzed in 2029 patients, including age, gender, Eastern Cooperative Oncology Group performance status, tumor type, number of involved vertebrae, further bone metastases, visceral metastases, interval from time of cancer diagnosis to the development of MSCC, time to the development of motor deficits, and ambulatory status. RESULTS: On multivariate analysis, Eastern Cooperative Oncology Group performance status, tumor type, bone metastases, visceral metastases, interval from cancer diagnosis to the development of metastatic spinal cord compression, time to the development of motor deficits, and ambulatory status were found to be significantly associated with survival. The risk score represented the sum of the scores for each of these factors, obtained from the probability of the patient dying within 2 months (shown as the percentage) divided by 10. Risk scores ranged between 6 and 25 points. At a cutoff value of ! 24 points, the specificity was 99.8% and the positive predictive value was 96.0%, which indicates that approximately 4% of the patients predicted to die within 2 months survived > 2 months. CONCLUSIONS: This score identifies patients who have a very poor survival with a high specificity and a high positive predictive value. Patients with a score of ! 24 points have a very high probability of dying within 2 months. Thus, overtreatment with in-

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

“…With 28 % of patients surviving more than 24 months, our results underline the potential of the use of new surgical approaches, particularly since surgery appears to be well tolerated. The characteristics of long-term survival patients were similar to classical prognostic factors [15], but it should be noticed that majority of these factors are related to the general status of patients (such as KPS or weight loss), whereas the type of surgery used, and the presence of surgical complications did not differ between the two groups.…”

A systematic review of prognostic factors predicting survival in patients with spinal bone metastases

“…Due to an increase in the survival times of patients with malignancies, the incidence of SBM is expected to rise over the years [1,2]. The majority of symptomatic SBM are caused by breast, prostate and lung cancer (56-74%) [3][4][5] and most commonly arise from the thoracic part of the spine (51-67%) [4,6]. Patients present with pain due to destruction of bone tissue and/or neurologic complaints due to nerve root and/or spinal cord compression [7,8].…”

Classification and scoring systems for metastatic spine tumors: a literature review

“…It was derived retrospectively Figure 4. Prognostic factors that were adopted by the 22 scoring systems 6,11,12,14,[42][43][44][45][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] . 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 articles Table 10.…”