Prognostic Factors and Functionality in Metastatic Spinal Cord Compression: Cohort Study
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n2.2160Keywords:
spinal cord compression, spinal neoplasms, neoplasm metastasis, prognosisAbstract
Introduction: Metastatic Spinal Cord Compression (MSCC) has great potential of irreversible loss of motor and sensory function, and it is considered an oncological emergency. Objective: Evaluate the prognosis of MSCC and the functionality of patients with solid tumors. Method: Cohort study was conducted in patients with cancer who developed MSCC between January 2017 and December 2018. Clinical and socio-demographic data were extracted from physical and electronic charts. Survival analysis was performed by the Kaplan-Meier method. Results: The study included 90 patients who were diagnosed with MSCC. At the time of MSCC diagnosis, 55.5% of patients were unable to walk. Patients with MSCC after lung cancer had 4.1-fold more odds of death (95% CI: 1.79-9.41; p=0.001), those with genitourinary tumors, 1.9-fold higher risk of death (95% CI: 1.06-3.45; p=0,02), and with other types of tumors, 3.1-fold higher risk of death (95% CI: 1.58-6.24; p=0.001) when compared with patients with MSCC after breast cancer. Conclusion: The clinical relevance of this study relies on the findings that the primary type of tumor is a predictive factor for overall survival of MSCC. More than half of the patients were unable to walk at the MSCC diagnosis.
Downloads
References
New PW, Cripps RA, Bonne Lee B. Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository. Spinal Cord. 2014;52(2):97-109. doi: https://doi.org/10.1038/sc.2012.165
New PW, Marshall R. International spinal cord injury data sets for non-traumatic spinal cord injury. Spinal Cord. 2014;52(2):123-32. doi: https://doi.org/10.1038/sc.2012.160
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: https://doi.org/10.3322/caac.21492
Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2019.
Silva GT, Bergmann A, Thuler LCS. Skeletal related events in patients with bone metastasis arising from non-small cell lung cancer. Support Care Cancer. 2016;24(2):731-6. doi: https://doi.org/10.1007/s00520-015-2835-1
Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20 Pt 2):6243s-9s. doi: https://doi.org/10.1158/1078-0432.CCR-06-0931
von Moos R, Body JJ, Egerdie B, et al. Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases. Support Care Cancer. 2016;24(3):1327-37. doi: https://doi.org/10.1007/s00520-015-2908-1
Di Martino A, Caldaria A, De vivo V, et al. Metastatic epidural spinal cord compression. Expert Rev Anticancer Ther. 2016;16(11):1189-98. doi: https://doi.org/10.1080/14737140.2016.1240038
Patnaik S, Turner J, Inaparthy P, et al. Metastatic spinal cord compression. Br J Hosp Med (Lond). 2020;81(4):1-10. doi: https://doi.org/10.12968/hmed.2019.0399
Lawton AJ, Lee KA, Cheville AL, et al. Assessment and management of patients with metastatic spinal cord compression: a multidisciplinary review. J Clin Oncol. 2019;37(1):61-71. doi: https://doi.org/10.1200/JCO.2018.78.1211
Loblaw DA, Perry J, Chambers A, et al. Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the cancer care ontario practice Guidelines Initiative’s Neuro-Oncology Disease Site Group. J Clin Oncol. 2005;23(9):2028-37. doi: https://doi.org/10.1200/JCO.2005.00.067
Mak KS, Lee LK, Mak RH, et al. Incidence and treatment patterns in hospitalizations for malignant spinal cord compression in the United States, 1998-2006. Int J Radiat Oncol Biol Phys. 2011;80(3):824-31. doi: https://doi.org/10.1016/j.ijrobp.2010.03.022
Silva GT, Bergmann A, Thuler LCS. Impact of symptomatic metastatic spinal cord compression on survival of patients with non-small-cell lung cancer. World Neurosurg. 2017;108:698-704. doi: https://doi.org/10.1016/j.wneu.2017.09.079
Lak AM, Rahimi A, Abunimer AM, et al. Quantifying the impact of surgical decompression on quality of life and identification of factors associated with outcomes in patients with symptomatic metastatic spinal cord compression. J Neurosurg Spine. 2020;33(2):237-44. doi: https://doi.org/10.3171/2020.1.SPINE191326
Tancioni F, Navarria P, Lorenzetti MA, et al. Multimodal approach to the management of metastatic epidural spinal cord compression (MESCC) due to solid tumors. Int J Radiat Oncol Biol Phys. 2010;78(5):1467-73. doi: https://doi.org/10.1016/j.ijrobp.2009.09.038
Pessina F, Navarria P, Carta GA, et al. Long-term follow-up of patients with metastatic epidural spinal cord compression from solid tumors submitted for surgery followed by radiation therapy. World Neurosurg. 2018;115:e681-e7. doi: https://doi.org/10.1016/j.wneu.2018.04.136
Younsi A, Riemann L, Scherer M, et al. Impact of decompressive laminectomy on the functional outcome of patients with metastatic spinal cord compression and neurological impairment. Clin Exp Metastasis. 2020;37(2):377-90. doi: https://doi.org/10.1007/s10585-019-10016-z
Scivoletto G, Lapenna LM, Di Donna V, et al. Neoplastic myelopathies and traumatic spinal cord lesions: an Italian comparison of functional and neurological outcomes. Spinal Cord. 2011;49(7):799-805. doi: https://doi.org/10.1038/sc.2011.6
Gedde MH, Lilleberg HS, Aßmus J, et al. Traumatic vs non-traumatic spinal cord injury: a comparison of primary rehabilitation outcomes and complications during hospitalization. J Spinal Cord Med. 2019;42(6):695-701. doi: https://doi.org/10.1080/10790268.2019.1598698
Fortin CD, Voth J, Jaglal SB, et al. Inpatient rehabilitation outcomes in patients with malignant spinal cord compression compared to other non-traumatic spinal cord injury: a population based study. J Spinal Cord Med. 2015;38(6):754-64. doi: https://doi.org/10.1179/2045772314Y.0000000278
Lei M, Yu J, Yan S, et al. Clinical outcomes and risk factors in patients with cervical metastatic spinal cord compression after posterior decompressive and spinal stabilization surgery. Ther Clin Risk Manag. 2019;15:119-27. doi: https://doi.org/10.2147/TCRM.S184497
He S, Wei H, Ma Y, et al. Outcomes of metastatic spinal cord compression secondary to primary hepatocellular carcinoma with multidisciplinary treatments. Oncotarget. 2017;8(26):43439-49. doi: https://doi.org/10.18632/oncotarget.15708
Silva GT, Costa TGP, Bessa CM, et al. Predictors of overall survival in non-small-cell lung cancer patients with metastatic spinal cord compression treated with short-course radiotherapy. Eur J Cancer Care (Engl). 2021;30(4):e13427. doi: https://doi.org/10.1111/ecc.13427
Rades D, Panzner A, Janssen S, et al. Outcomes after radiotherapy alone for metastatic spinal cord compression in patients with oligo-metastatic breast cancer. Anticancer Res. 2018;38(12):6897-903. doi: https://doi.org/10.21873/anticanres.13066
Rades D, Weber A, Karstens JH, et al. Prognostic role of the number of involved extraspinal organs in patients with metastatic spinal cord compression. Clin Neurol Neurosurg. 2014;118:12-5. doi: https://doi.org/10.1016/j.clineuro.2013.12.007
Tabouret E, Gravis G, Cauvin C, et al. Long-term survivors after surgical management of metastatic spinal cord compression. Eur Spine J. 2015;24(1):209-15. doi: https://doi.org/10.1007/s00586-014-3676-1
Lun DX, Chen NW, Feng JT, et al. Visceral metastasis: a prognostic factor of survival in patients with spinal metastases. Orthopc Surg. 2020;12(2):552-60. doi: https://doi.org/10.1111/os.12657
Pitz MW, Musto G, Navaratnam S. Sex as an independent prognostic factor in a population-based non-small cell lung cancer cohort. Can Respir J. 2013;20(1):30-4. doi: https://doi.org/10.1155/2013/618691
Karimi D, Morgen SS, Fruergaard S, et al. Long-term survival after surgical treatment of spinal metastasis - the predictive role of sex. Anticancer Res. 2020;40(3):1475-9. doi: https://doi.org/10.21873/anticanres.14091
Feng JT, Yang XG, Wang F, et al. Prognostic discrepancy on overall survival between ambulatory and nonambulatory patients with metastatic spinal cord compression. World Neurosurg. 2019;121:e322-e32. doi: https://doi.org/10.1016/j.wneu.2018.09.102
Published
How to Cite
Issue
Section
License
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
This work is licensed under a Creative Commons Attribution 4.0 International License.
