title: Predicting survival of patients with metastatic epidural spinal cord compression from cancer of the head-and-neck.
abstract: OBJECTIVE
  To develop an instrument for estimating survival after irradiation for metastatic epidural spinal cord compression (MESCC) from head and neck cancer.
  
  
  METHODS
  In 58 patients, eleven factors were evaluated for influence on survival: age, gender, performance status, tumor site, time from cancer diagnosis until MESCC, affected vertebrae, walking ability, further osseous lesions, organ metastases, time developing motor deficits and radiation regimen. Factors with significant association with survival or a trend (multivariate analysis) were used for scoring.
  
  
  RESULTS
  Walking ability, visceral metastases and time to developing motor deficits were included in the score. Scoring points were calculated by dividing 6-month survival rates by 10. Patients' scores were obtained from adding the points of the three factors. Four groups were created, 7-10, 12-15, 16-18 and 21 points. Six-month survival rates were 0%, 27%, 71% and 100% (p<0.001).
  
  
  CONCLUSIONS
  With this new instrument, one can estimate 6-month survival probabilities of patients with MESCC from head-and-neck cancer.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: Department of Radiation Oncology, Hannover Medical University, Hannover, Germany.
authors.forename: Johann H
authors.initials: JH
authors.lastname: Karstens
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Lübeck, Lübeck, Germany.
authors.forename: Samer G
authors.initials: SG
authors.lastname: Hakim
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000401:mortality*; D013125:Spinal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary
keywords: Head-and-neck cancer; irradiation; metastatic epidural spinal cord compression; predictive instrument; survival