Survival analysis of 459 adult patients with primary spinal cancer in England and Wales: a population-based study.
BACKGROUND
Primary spinal gliomas are rare. Because data from the Cancer Registry of England and Wales covered larger numbers of patients and longer durations of follow-up, our objective was to define prognostic factors for survival at a national population level.


METHODS
From 1971 to 1995, data on 459 adult patients (age, >15 years) with primary spinal cancer from the Cancer Registry of England and Wales were analyzed. Median survival and CSRs with respect to 7 variables (age, sex, morphology, WHO grade, socioeconomic status, geographic region, and period of diagnosis) were calculated using the Kaplan-Meier method. Cox regression was performed for estimating HRs for death.


RESULTS
The median survival and the 1-, 5-, and 10-year CSRs for the population were 10.2 years, 78.7%, 59.7%, and 50.5%, respectively. Univariate analysis revealed that age at diagnosis, morphology, WHO grade, and period of diagnosis affected the CSR. Multivariate analysis demonstrated 3 factors influencing survival: older age (ie, >60 years; HR = 2.67; P < .001), non-ependymomas (HR = 3.51; P < .001), and high-grade tumors (HR = 3.01; P < .001). The improved survival in recent periods was associated with an increased number of diagnosed ependymomas.


CONCLUSIONS
This study identifies old age, non-ependymomas, and high-grade tumors as negative prognostic factors for patient survival. The results from this population-based study are very helpful for comparison with those of other hospital-based studies and for public health purposes.
Tseng
Jen-Ho
JH
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan.
Tseng
Ming-Yuan
MY
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004739:England / Q000453:epidemiology; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D017678:Sex Distribution; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate; D014852:Wales / Q000453:epidemiology