Metastatic Spinal Cord Compression: A Survival Score Particularly Developed for Elderly Prostate Cancer Patients.
OBJECTIVE
Metastatic spinal cord compression (MSCC) is an oncological emergency. Many elderly patients cannot tolerate intensive treatment and need individual approaches accounting for a patient's remaining lifetime. The goal of the present study was to develop a survival score for elderly prostate cancer patients with MSCC.


METHODS
Nine characteristics were analyzed in 243 patients: age, performance status, interval from prostate cancer diagnosis until MSCC, affected vertebrae, ambulatory status, further bone lesions, visceral metastases, time developing motor deficits, fractionation schedule.


RESULTS
Pre-radiotherapy ambulatory status (p<0.001), visceral metastases (p<0.001) and time developing motor deficits (p<0.001) were significant for survival on Cox regression analysis and included in the survival score. Four groups were defined: 9-12, 13-16, 17-19 and 21-23 points. Six-month survival rates were 7%, 28%, 71% and 95%, respectively (p<0.001).


CONCLUSIONS
The present study identified four groups with different survival probabilities that require treatment strategies with different priorities ranging from symptom control to prolongation of life.
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, Cruces University Hospital, Barakaldo, Vizcaya, Spain.
Jon
J
Cacicedo
Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Barbara
B
Segedin
Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, the Netherlands.
Theo
T
Veninga
Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ, U.S.A.
Steven E
SE
Schild
D000368:Aged; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; 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
Prostate cancer; elderly patients; irradiation; metastatic epidural spinal cord compression; overall survival