A Tool to Estimate Survival of Elderly Patients Presenting with Metastatic Epidural Spinal Cord Compression (MESCC) from Cancer of Unknown Primary.
OBJECTIVE
Cancers of unknown primary (CUP) account for about 10% in elderly patients with MESCC. Immediate treatment is indicated. Personalizing treatment for MESCC requires for clear understanding of the patients' survival prognosis. In this case, a tool for estimating survival would be valuable.


METHODS
In 104 elderly CUP patients, nine factors were investigated: age, gender, performance score, number of affected vertebrae, ability to walk at presentation for radiotherapy, additional bone metastases, visceral metastases, time developing motor weakness, radiotherapy program.


RESULTS
In multivariate analysis, the ability to walk (p=0.011) and visceral metastases (p<0.001) were associated with survival. The following scores were assigned: unable to walk=0, able to walk=1, visceral metastases=0, no visceral metastases=1. Three groups were formed (0, 1 and 2 points) with 6-month survival rates of 7%, 18% and 73% (p<0.001).


CONCLUSIONS
This specific tool assists the physician to estimate survival and select for the most suitable radiotherapy program in elderly CUP patients with MESCC.
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net.
Dirk
D
Rades
Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain.
Antonio J
AJ
Conde-Moreno
Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón, Spain.
Raquel
R
Garcia
Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, the Netherlands.
Theo
T
Veninga
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Steven E
SE
Schild
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009382:Neoplasms, Unknown Primary / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013117:Spinal Cord Compression / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D013125:Spinal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D015996:Survival Rate
Cancer of unknown primary; MESCC; elderly; radiation therapy; survival tool