Predicting survival for surgery of metastatic spinal cord compression in prostate cancer: a new score
2012 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 37, no 26, 2168-2176 p.Article in journal (Other academic) Published
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.
Patients and methods The study comprised 68 consecutive patients with prostate cancer operated for metastatic spinal cord compression at Umeå University Hospital, Sweden. 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.
Place, publisher, year, edition, pages
2012. Vol. 37, no 26, 2168-2176 p.
prostate cancer, bone metastasis, spinal cord compression, prognostic score
Orthopedics Cancer and Oncology
Research subject Orthopaedics; Oncology
IdentifiersURN: urn:nbn:se:umu:diva-54459DOI: 10.1097/BRS.0b013e31826011bcOAI: oai:DiVA.org:umu-54459DiVA: diva2:523863
Included in thesis in submitted form.2012-04-272012-04-262013-01-29Bibliographically approved