title: Breast cancer patients with metastatic spinal cord compression. Number of extraspinal organs involved by metastases influences survival.
abstract: OBJECTIVE
  The goal of the present work was to investigate the predictive value of the number of extraspinal organs involved by metastases for the survival of patients with metastatic spinal cord compression (MSCC) from breast cancer.
  
  
  METHODS
  Data of 145 breast cancer patients who received 10 fractions of 3 Gy of radiotherapy (RT) alone for MSCC were retrospectively analyzed. Seven potential prognostic factors were investigated including age, Eastern Cooperative Oncology Group (ECOG) performance score, number of involved vertebrae, interval from breast cancer diagnosis to RT of MSCC, ambulatory status prior to RT, time to developing motor deficits, and the number of involved extraspinal organs.
  
  
  RESULTS
  The 1-year survival rates for involvement of 0, 1, 2, and ≥ 3 extraspinal organs were 86, 73, 36, and 16 % (p < 0.001). In the multivariate analysis, the number of involved extraspinal organs remained significant (risk ratio 2.19; 95 % confidence interval 1.61-3.00; p < 0.001). ECOG performance score (p < 0.001), ambulatory status prior to RT (p = 0.003), and the time to developing motor deficits (p < 0.001) were also significantly associated with survival in the multivariate analysis.
  
  
  CONCLUSIONS
  The number of extraspinal organs involved by metastases is an independent prognostic factor of survival in patients with MSCC from breast cancer.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Bartscht
authors.forename: J H
authors.initials: JH
authors.lastname: Karstens
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
authors.forename: D
authors.initials: D
authors.lastname: Rades
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D016019:Survival Analysis