59.
Changes in cancer survival could affect pre-operative scoring systems
in patients with metastatic spinal cord compression (MSCC)
Søren Schmidt Morgen, Casper Lund-Andersen, Claus Falck Larsen, Rikke
Søgaard, Svend Aage Engelholm, Benny Dahl
Spine Section, Department of Orthopaedic Surgery Rigshospitalet ; Spine
Section, Department of Orthopaedic Surgery, Rigshospitalet ; Trauma Center,
Rigshospitalet ; Centre for Applied Health Services Research and Technology
Assessment, University of Southern Denmark; Department of Radiation
Therapy, Rigshospitalet ; Spine Section, Department of Orthopaedic Surgery,
Rigshospitalet
Background:
An increasing number of patients are being surgically treated for
MSCC. Among the reasons for this development is high evidence clinical
studies, improved surgical techniques and the increasing number of patients
being treated for an oncologic condition. Combined with improvements in
oncologic treatment this development will most likely continue. Pre-operative
scoring systems are routinely used in the evaluation of these patients, and the
primary oncologic diagnosis is an important variable in all these systems. Until
now, the calculation and impact of this diagnosis have been assessed in smaller
groups of patients included in older studies.
Purpose / Aim of Study:
To estimate whether one-year survival in MSCC
patients referred for surgical evaluation is associated with the oncologic
diagnosis.
Materials and Methods:
All patients referred to Rigshospitalet suspected of
acute symptoms caused by spinal metastases from January 1st 2005 to
December 31st, 2010. For all patients primary tumor, conservative vs. surgical
treatment and one-year survival was registered.
Findings / Results:
A total of 2380 patients were referred in the study period.
The overall one-year survival did not change significantly from 2005 to 2010,
but for patients with pulmonary cancer there was a significant increase in one-
year survival in the study period (p < 0.05). The finding was identical in
patients undergoing surgical treatment.
Conclusions:
Patients with MSCC from pulmonary cancer experienced
improved survival in the study period, compared to patients with other
oncologic diagnosis. This corresponds to reports from oncological studies and
could affect the pre-operative scoring systems, where assignment of point
based on primary tumor is an important variable in the prognostic evaluation.
