title: A new prognostic factor for the survival of patients with renal cell carcinoma developing metastatic spinal cord compression.
abstract: OBJECTIVE
  This study aimed to identify a potential association of the number of involved extraspinal organs with the survival of patients with metastatic spinal cord compression (MSCC) from renal cell carcinoma.
  
  
  METHODS
  Data of 69 patients irradiated for MSCC from renal cell carcinoma were retrospectively evaluated for survival. The prognostic value of the number of involved extraspinal organs and eight additional factors were investigated. These additional factors included age, gender, performance status, number of involved vertebrae, interval from cancer diagnosis to radiotherapy (RT) of MSCC, ambulatory status prior to RT, time developing motor deficits, and the fractionation regimen (30 Gy in 10 fractions vs. higher doses).
  
  
  RESULTS
  The 6-month survival rates for involvement of 0, 1, and ≥ 2 extraspinal organs were 93, 57, and 21%, respectively (p < 0.001). In the multivariate analysis, the number of involved extraspinal organs maintained significance (risk ratio 2.65; 95% confidence interval 1.64-4.52; p < 0.001). The interval from cancer diagnosis to RT of MSCC (p = 0.013) and ambulatory status prior to RT (p = 0.002) were also independent predictors of survival.
  
  
  CONCLUSIONS
  The number of involved extraspinal organs is a new prognostic factor of survival in patients with MSCC from renal cell carcinoma and should be considered in future clinical trials.
authors.affiliation: Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, 23538, Ratzeburger Allee 160, Lübeck, Germany, Rades.Dirk@gmx.net.
authors.forename: D
authors.initials: D
authors.lastname: Rades
authors.forename: A
authors.initials: A
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Bartscht
authors.forename: A
authors.initials: A
authors.lastname: Bajrovic
authors.forename: J H
authors.initials: JH
authors.lastname: Karstens
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary*; D015984:Causality; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000401:mortality* / Q000517:prevention & control; D013125:Spinal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary*; D016019:Survival Analysis; D016896:Treatment Outcome