Predicting survival of patients with metastatic epidural spinal cord compression from cancer of the head-and-neck

Abstract

Aim: To develop an instrument for estimating survival after irradiation for metastatic epidural spinal cord compression (MESCC) from head and neck cancer.

Patients and methods: In 58 patients, eleven factors were evaluated for influence on survival: age, gender, performance status, tumor site, time from cancer diagnosis until MESCC, affected vertebrae, walking ability, further osseous lesions, organ metastases, time developing motor deficits and radiation regimen. Factors with significant association with survival or a trend (multivariate analysis) were used for scoring.

Results: Walking ability, visceral metastases and time to developing motor deficits were included in the score. Scoring points were calculated by dividing 6-month survival rates by 10. Patients' scores were obtained from adding the points of the three factors. Four groups were created, 7-10, 12-15, 16-18 and 21 points. Six-month survival rates were 0%, 27%, 71% and 100% (p<0.001).

Conclusion: With this new instrument, one can estimate 6-month survival probabilities of patients with MESCC from head-and-neck cancer.

Keywords: Head-and-neck cancer; irradiation; metastatic epidural spinal cord compression; predictive instrument; survival.