title: Long-term survivors after surgical management of metastatic spinal cord compression.
abstract: OBJECTIVE
  Metastatic spinal cord compression (MSCC) incidences are increasing. Our objective was to identify predictive factors involved in long-term survival after use of a surgical approach.
  
  
  METHODS
  We retrospectively analyzed all patients referred to our institution for MSCC who underwent surgery (N = 138). We identified patients with an overall survival (OS) rate greater than 2 years, compared their characteristics to the remaining patients, and performed recursive partitioning analysis (RPA).
  
  
  RESULTS
  Median OS was 7.8 months (95 % confidence interval 4.4-11.2). Thirty-nine patients presented with OS ≥2 years. A comparative analysis found significant differences concerning the delay (first symptom-surgery, p < 0.001), number of systemic (p = 0.001) or bone metastases (p = 0.013), Karnofsky performance status (KPS) (p = 0.006), Frankel (p = 0.025), ASA scores (p < 0.001), weight loss (p = 0.003), hyperalgia (p = 0.002), chemotherapy use (p = 0.034), and primary tumor (p < 0.001). RPA classification identified six prognostic classes based on the ASA score, primary type, KPS, and systemic metastases.
  
  
  CONCLUSIONS
  Long-term metastatic cancer survivor patients are an increasing population with specific characteristics.
authors.affiliation: Institut Paoli Calmettes, Departement of Medical Oncology, 232 Bd Sainte Marguerite, 13009, Marseille, France, emeline.tabouret@gmail.com.
authors.forename: Emeline
authors.initials: E
authors.lastname: Tabouret
authors.forename: G
authors.initials: G
authors.lastname: Gravis
authors.forename: C
authors.initials: C
authors.lastname: Cauvin
authors.forename: A
authors.initials: A
authors.lastname: Loundou
authors.forename: T
authors.initials: T
authors.lastname: Adetchessi
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D061665:Time-to-Treatment; D015431:Weight Loss; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents