title: A survival score for patients with metastatic spinal cord compression from prostate cancer.
abstract: BACKGROUND
  This study aimed to develop and validate a survival scoring system for patients with metastatic spinal cord compression (MSCC) from prostate cancer.
  
  
  METHODS
  Of 436 patients, 218 patients were assigned to the test group and 218 patients to the validation group. Eight potential prognostic factors (age, performance status, number of involved vertebrae, ambulatory status, other bone metastases, visceral metastases, interval from cancer diagnosis to radiotherapy of MSCC, time developing motor deficits) plus the fractionation regimen were retrospectively investigated for associations with survival. Factors significant in the multivariate analysis were included in the survival score. The score for each significant prognostic factor was determined by dividing the 6-month survival rate (%) by 10. The total score represented the sum of the scores for each factor. The prognostic groups of the test group were compared to the validation group.
  
  
  RESULTS
  In the multivariate analysis of the test group, performance status, ambulatory status, other bone metastases, visceral metastases, and interval from cancer diagnosis to radiotherapy were significantly associated with survival. Total scores including these factors were 20, 21, 22, 24, 26, 28, 29, 30, 31, 32, 33, 35, 37, or 39 points. In the test group, the 6-month survival rates were 6.5% for 20-24 points, 44.6% for 26-33 points, and 95.8% for 35-39 points (p < 0.0001). In the validation group, the 6-month survival rates were 7.4%, 45.4%, and 94.7%, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  Because the survival rates of the validation group were almost identical to the test group, this score can be considered valid and reproducible.
authors.affiliation: Department of Radiation Oncology, University of Lubeck, Germany. Rades.Dirk@gmx.net
authors.forename: D
authors.initials: D
authors.lastname: Rades
authors.forename: S
authors.initials: S
authors.lastname: Douglas
authors.forename: T
authors.initials: T
authors.lastname: Veninga
authors.forename: A
authors.initials: A
authors.lastname: Bajrovic
authors.forename: L J A
authors.initials: LJ
authors.lastname: Stalpers
authors.forename: P J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: V
authors.initials: V
authors.lastname: Rudat
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000532:radiotherapy; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000209:etiology* / Q000401:mortality* / Q000517:prevention & control; D013125:Spinal Neoplasms / Q000150:complications* / Q000401:mortality / Q000517:prevention & control / Q000556:secondary*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome