BACKGROUND CONTEXT: Prediction models for outcome of decompressive surgical resection of spinal epidural metastases (SEM) have in common that they have been developed for all types of SEM, irrespective of the type of primary tumor.
It is our experience in clinical practice, however, that these models often fail to accurately predict outcome in the individual patient.
PURPOSE: To investigate whether decision making could be optimized by applying tumor specific prediction models. For proof of concept we analyzed patients with SEM from renal cell carcinoma that we have operated on.
STUDY DESIGN/SETTING: Retrospective chart analysis 2006-2012.
PATIENT SAMPLE: 21 consecutive patients with symptomatic SEM of renal cell carcinoma.
OUTCOME MEASURES: Predictive factors for survival.
METHODS: The study was supported by a grant from our institution. Next to established predictive factors for survival, we analyzed the predictive value of the Motzer criteria in these patients. The Motzer criteria encomprises a specific and validated risk model for survival in patients with renal cell carcinoma.
RESULTS: After multivariable analysis only Motzer intermediate (HR 17.4, 95%CI 1.82-166, p=0.01) and high risk (HR39.3, 95%CI 3.10-499, p=0.005) turned out to be significantly associated with survival in patients with renal cell carcinoma that we have operated on.
CONCLUSIONS: In this study we have demonstrated that decision making could have been optimized by implementing the Motzer criteria next to established prediction models. We therefore suggest that in future patients with SEM from renal cell carcinoma the Motzer criteria are also taken into account.
Written by:
Bakker NA, Coppes MH, Vergeer RA, Kuijlen JM, Groen RJ. Are you the author?
Department of Neurosurgery, University Medical Center Groningen, University of Groningen, The Netherlands.
Reference: Spine J. 2014 Apr 22. pii: S1529-9430(14)00400-8.
doi: 10.1016/j.spinee.2014.04.013
PubMed Abstract
PMID: 24768747
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