title: Prognostic factors and a survival score for patients with metastatic spinal cord compression from colorectal cancer.
abstract: BACKGROUND
  This study aimed to identify independent prognostic factors and to create a survival score for patients with metastatic spinal cord compression (MSCC) from colorectal cancer (CRC).
  
  
  METHODS
  Data from 121 patients irradiated for MSCC from CRC were retrospectively analyzed. Eleven potential prognostic factors were investigated including tumor type, age, gender, Eastern Cooperative Oncology Group performance status score (ECOG-PS), number of involved vertebrae, ambulatory status prior to radiotherapy (RT), other bone metastases, visceral metastases, interval from cancer diagnosis to RT of MSCC, time of developing motor deficits prior to RT, and the RT schedule.
  
  
  RESULTS
  On multivariate analysis, improved motor function was significantly associated with an ECOG-PS of 1-2 (p = 0.011) and a slower development of motor deficits (p < 0.001). Improved local control was significantly associated with absence of visceral metastases (p = 0.043) and longer-course RT (p = 0.008). Improved survival was significantly associated with an ECOG-PS of 1-2 (p < 0.001), ambulatory status (p < 0.001), absence of visceral metastases (p < 0.001), and a slower development of motor deficits (p = 0.047). These four prognostic factors were included in a survival score. The score for each factor was determined by dividing the 6-month survival rate by 10. The prognostic score represented the sum of the factor scores. Four prognostic groups were designed; the 6-month survival rates were 0% for 8-12 points, 26% for 13-18 points, 62% for 20-23 points, and 100% for 24-27 points (p < 0.001).
  
  
  CONCLUSIONS
  This study identified several independent prognostic factors for treatment outcomes in patients irradiated for MSCC from CRC. The survival prognosis of these patients can be estimated with a new score.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, 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: S
authors.initials: S
authors.lastname: Huttenlocher
authors.forename: T
authors.initials: T
authors.lastname: Veninga
authors.forename: A
authors.initials: A
authors.lastname: Bajrovic
authors.forename: V
authors.initials: V
authors.lastname: Rudat
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015233:Models, Statistical; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009460:Neurologic Examination / Q000528:radiation effects; D011379:Prognosis; D019233:Retreatment; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D015996:Survival Rate