Metastatic Spinal Cord Compression from Non-Small-Cell Lung Cancer Treated with Surgery and Adjuvant Therapies: A Retrospective Analysis of Outcomes and Prognostic Factors in 116 Patients.
BACKGROUND
Metastatic spinal cord compression is a disastrous consequence of non-small-cell lung cancer (NSCLC). There have been few studies of the outcomes or prognostic factors in patients with metastatic spinal cord compression from NSCLC treated with surgery and adjuvant therapies.


METHODS
From 2002 to 2013, 116 patients with metastatic spinal cord compression from NSCLC treated with surgery and adjuvant therapies were enrolled in this retrospective analysis. Kaplan-Meier methods and Cox regression analysis were used to estimate overall survival and identify prognostic factors for survival.


RESULTS
Multivariate analysis suggested that the Eastern Cooperative Oncology Group performance status (ECOG-PS), preoperative and postoperative Frankel scores, postoperative adjuvant radiation therapy, and target therapy were independent prognostic factors. Ninety patients died at a median of twelve months (range, three to forty-seven months) postoperatively, and twenty-six patients were still alive at the time of final follow-up (at a median of fifteen months [range, five to fifty-four months]).


CONCLUSIONS
The complete disappearance of deficits in spinal cord function after surgery was the most robust predictor of survival. Adjuvant radiation therapy and target therapy were also associated with a better prognosis.


METHODS
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, No. 2, Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China. E-mail address for Y. Zhou: happyzhou@vip.163.com.
Yu
Y
Tang
Department of Orthopaedic Surgery, No. 44 Military Hospital, No. 67 Huang He Road, Xiao He District, Guiyang, Guizhou 550009, People's Republic of China.
Jintao
J
Qu
Department of Pharmacy, General Hospital of Chengdu Military Region, Chengdu 610083, People's Republic of China.
Juan
J
Wu
Department of Bone Tumors, Changzheng Hospital, The Second Military Medical University, No. 415 Feng Yang Road, Huang Pu District, Shanghai 200003, People's Republic of China. E-mail address for J. Xiao: 77239090@qq.com.
Song
S
Li
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, No. 2, Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China. E-mail address for Y. Zhou: happyzhou@vip.163.com.
Yue
Y
Zhou
Department of Bone Tumors, Changzheng Hospital, The Second Military Medical University, No. 415 Feng Yang Road, Huang Pu District, Shanghai 200003, People's Republic of China. E-mail address for J. Xiao: 77239090@qq.com.
Jianru
J
Xiao
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000401:mortality; D059352:Musculoskeletal Pain / Q000517:prevention & control; D060787:Neoplasm Grading; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant / Q000401:mortality; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology*; D013125:Spinal Neoplasms / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome