title: A new instrument for estimating the survival of patients with metastatic epidural spinal cord compression from esophageal cancer.
abstract: BACKGROUND
  This study was initiated to create a predictive instrument for estimating the survival of patients with metastatic epidural spinal cord compression (MESCC) from esophageal cancer.
  
  
  METHODS
  In 27 patients irradiated for MESCC from esophageal cancer, the following nine characteristics were evaluated for potential impact on survival: age, gender, Eastern Cooperative Oncology Group (ECOG) performance score, histology, number of involved vertebrae, ambulatory status before irradiation, further bone metastases, visceral metastases, and dynamic of developing motor deficits before irradiation. In addition, the impact of the radiation regimen was investigated. According to Bonferroni correction, p-values of < 0.006 were significant representing an alpha level of < 0.05.
  
  
  RESULTS
  ECOG performance score (p < 0.001), number of involved vertebrae (p = 0.005), and visceral metastases (p = 0.004) had a significant impact on survival and were included in the predictive instrument. Scoring points for each characteristic were calculated by dividing the 6-months survival rates (in %) by 10. The prognostic score for each patient was obtained by adding the scoring points of the three characteristics. The prognostic scores were 4, 9, 10, 14 or 20 points. Three prognostic groups were formed, 4 points (n = 11), 9-14 points (n = 12) and 20 points (n = 4). The corresponding 6-months survival rates were 0%, 33% and 100%, respectively (p < 0.001). Median survival times were 1 month, 5 months and 16.5 months, respectively.
  
  
  CONCLUSIONS
  This new instrument allows the physician estimate the 6-months survival probability of an individual patient presenting with MESCC from esophageal cancer. This is important to know for optimally personalizing the treatment of these patients.
authors: Department of Radiation Oncology, University of Lubeck, Lubeck, Germany.
authors: Dirk
authors: D
authors: Rades
authors: Department of Radiation Oncology, University of Lubeck, Lubeck, Germany.
authors: Stefan
authors: S
authors: Huttenlocher
authors: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors: Amira
authors: A
authors: Bajrovic
authors: Department of Radiation Oncology, Hannover Medical School, Hannover, Germany.
authors: Johann H
authors: JH
authors: Karstens
authors: Department of Hematology and Medical Oncology, University of Lubeck, Lubeck, Germany.
authors: Tobias
authors: T
authors: Bartscht
keywords: epidural; esophageal cancer; irradiation; metastatic; predictive instrument; spinal cord compression; survival