STUDY DESIGN: We retrospectively analyzed prognostic factors for survival in prostate cancer patients operated for metastatic spinal cord compression.
OBJECTIVE: The aim was to obtain a clinical score for prediction of survival after surgery.
SUMMARY OF BACKGROUND DATA: Survival prognosis is important when deciding about treatment of patients with metastatic spinal cord compression. The criteria for identifying prostate cancer patients who may benefit from surgical treatment are unclear.
METHODS: The study comprised 68 consecutive patients with prostate cancer operated for metastatic spinal cord compression at XX University Hospital, XX. The indication for surgery was neurological deficit; 53 patients had hormone-refractory prostate cancer, and 15 patients had previously untreated, hormone-naïve prostate cancer. In 42 patients posterior decompression was performed and 26 patients were operated with posterior decompression and stabilization.
RESULTS: A new score for prediction of survival was developed based on the results of survival analyses. The score includes: hormone status of prostate cancer, Karnofsky performance status, evidence of visceral metastasis, and preoperative serum PSA. The total scores ranged from 0 to 6. Three prognostic groups were formulated: group A (n = 32) with scores 0-1; group B (n = 23) with scores 2-4, and group C (n = 12) with scores 5-6. The median overall survival was 3 (0.3 - 20) months in group A, 16 (1.8 - 59) months in group B, and in group C more than half (7 of 12) of patients were still alive.
CONCLUSION: We present a new prognostic score for predicting survival of prostate cancer patients after surgery for metastatic spinal cord compression. The score is easy to apply in clinical practice and may be used as additional support when making decision about treatment.
Written by:
Crnalic S, Löfvenberg R, Bergh A, Widmark A, Hildingsson C Are you the author?
From the *Department of Surgical and Perioperative Sciences (Orthopedics); †Department of Biomedical Sciences (Pathology); and ‡Department of Radiation Sciences (Oncology), Umeå University, Umeå, Sweden
Reference: Spine (Phila Pa 1976). 2012 May 29
doi: 10.1097/BRS.0b013e31826011bc
PubMed Abstract
PMID: 22648028