Prognostic factors for survival in metastatic spinal cord compression: a retrospective study in a rehabilitation setting.
OBJECTIVE
Metastatic spinal cord compression (MSCC) occurs in 5-10% of all patients with cancer, and it is associated with short survival durations. Patients with MSCC may also have functional loss and require rehabilitation before discharge from the hospital. The purposes of this retrospective study were to identify clinical and social variables that had a significant impact on survival of patients with MSCC who underwent inpatient rehabilitation.


METHODS
A total of 60 consecutive patients with MSCC who were admitted to the inpatient rehabilitation unit at our tertiary care cancer center between 1996 and 1998 were included. Age, discharge destination, primary tumor site, metastasis, comorbidity, hemoglobin and albumin levels, treatment rendered for MSCC, opioids used, and psychological symptoms were examined as variables, and the Kaplan-Meier survival analysis was used.


RESULTS
Our study showed that most of the variables we examined had no significant influence on survival time (median, 4.1 mo), with the exception of gastrointestinal cancer; patients with gastrointestinal cancer had a poorer prognosis (median survival durations, 0.6 mo; P < 0.0001). We also found a 1-mo gap between the time of diagnosis and the time of transfer to the rehabilitation unit.


CONCLUSIONS
This study suggests that rehabilitation programs for patients with MSCC should be of short duration and that early referral (i.e., when the patient is diagnosed of MSCC) to the rehabilitation service should be encouraged.
Guo
Ying
Y
Department of Palliative Care and Rehabilitation Medicine, University of Texas, M. D. Anderson Cancer Center, Houston 77030, USA.
Young
Beth
B
Palmer
J Lynn
JL
Mun
Yong
Y
Bruera
Eduardo
E
D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology* / Q000534:rehabilitation; D013125:Spinal Neoplasms / Q000401:mortality* / Q000534:rehabilitation / Q000556:secondary*; D015996:Survival Rate