Prognostic role of the number of involved extraspinal organs in patients with metastatic spinal cord compression

Abstract

Objective: This study was investigated the prognostic role of the number of involved extraspinal organs in the survival of patients with metastatic spinal cord compression (MSCC).

Methods: Data of 552 patients treated with 30Gy in 10 fractions of radiotherapy (RT) alone for MSCC were retrospectively analyzed. In addition to the number of involved extraspinal organs, eight potential prognostic factors were investigated including age, gender, Eastern Cooperative Oncology Group performance score (ECOG-PS), primary tumor type, number of involved vertebrae, interval from cancer diagnosis to RT, pre-RT ambulatory status, and time developing motor deficits.

Results: The 6-month survival rates for the involvement of 0, 1, 2, 3, and ≥4 extraspinal organs were 88%, 55%, 30%, 13%, and 12%, respectively (P<0.001). In the multivariate analysis, number of involved extraspinal organs maintained significance (risk ratio 1.61; 95%-confidence interval 1.47-1.77; P<0.001). On multivariate analysis, gender (P=0.017), ECOG-PS (P<0.001), primary tumor type (P<0.001), interval from cancer diagnosis to RT (P<0.001), pre-RT ambulatory status (P<0.001), and time developing motor deficits (P<0.001) were also independent predictors for survival.

Conclusions: The number of involved extraspinal organs is a new and independent prognostic factor in patients with MSCC and should be considered in future clinical trials.

Keywords: Involved extraspinal organs; Metastatic spinal cord compression; Prognostic value; Radiotherapy; Survival.