Published in:
01-06-2013 | Original Article
Risk factors for survival of 106 surgically treated patients with symptomatic spinal epidural metastases
Published in: European Spine Journal | Issue 6/2013
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Purpose
Evaluation of risk factors for survival in patients surgically treated for symptomatic spinal epidural metastases (SEM).
Methods
One hundred and six patients who were surgically treated for symptomatic SEM in a 10-year period in two cooperatively working hospitals were retrospectively studied for nine risk factors: age, gender, site of the primary tumor, location of the symptomatic spinal metastasis, functional and neurologic status, the presence of visceral metastases and the presence of other spinal and extraspinal bone metastases. Analysis was performed using the Kaplan–Meier method, univariate log-rank tests and Cox-regression models.
Results
Overall median survival was 10.7 months (0.2–107.5 months). Overall 30-day complication rate was 33 %. Multivariate Cox-regression analysis showed that fast growing primary tumors (HR 3.1, 95 % CI 1.6–6.2, p = 0.001), the presence of visceral metastases (HR 1.7, 95 % CI 1.0–2.9, p = 0.033) and a low performance status (HR 2.7, 95 % CI 1.1–6.6, p = 0.025) negatively influenced the survival.
Conclusion
Primary tumor type, presence of visceral metastases and performance status are significant predictors for survival after surgery for symptomatic SEM and should be evaluated before deciding on the extent of treatment. More accurate prediction models are needed to select the best treatment option for the individual patient.