A new instrument for estimating the survival of patients with metastatic epidural spinal cord compression from esophageal cancer

  • Dirk Rades Department of Radiation Oncology University of Lübeck
  • Stefan Huttenlocher Department of Radiation Oncology University of Lübeck
  • Amira Bajrovic Department of Radiation Oncology, University Medical Center Eppendorf
  • Johann H Karstens Department of Radiation Oncology, Hannover Medical School
  • Tobias Bartscht Department of Hematology and Medical Oncology, University of Lübeck

Abstract

Background: This study was initiated to create a predictive instrument for estimating the survival of patients with metastatic epidural spinal cord compression (MESCC) from esophageal cancer.

Methods: In 27 patients irradiated for MESCC from esophageal cancer, the following nine characteristics were evaluated for potential impact on survival: age, gender, Eastern Cooperative Oncology Group (ECOG) performance score, histology, number of involved vertebrae, ambulatory status before irradiation, further bone metastases, visceral metastases, and dynamic of developing motor deficits before irradiation. In addition, the impact of the radiation regimen was investigated. According to Bonferroni correction, p-values of <0.006 were significant representing an alpha level of <0.05.

Results: ECOG performance score (p<0.001), number of invlved vertebrae (p=0.005), and visceral metastases (p=0.004) had a significant impact on survival and were included in the predictive instrument. Scoring points for each characteristic were calculated by dividing the 6-months survival rate (in %) by 10. The prognostic score for each patient was obtained by adding the scoring points of the three characteristics. The prognostic scores were 4, 9, 10, 14 or 20 points. Three prognostic groups were formed, 4 points (n=11), 9-14 points (n=12), and 20 points (n=4). The corresponding 6-months survival rates were 0%, 33% and 100%, respectively (p<0.001). Median survival times were 1 month, 5 months and 16.5 months, respectively.

Conclusions: This new instrument allows the physician estimate the 6-months survival probability of an individual patient presenting with MESCC from esophageal cancer. This is important to know for optimally personalizing the treatment of these patients.

 

Author Biographies

Dirk Rades, Department of Radiation Oncology University of Lübeck
Stefan Huttenlocher, Department of Radiation Oncology University of Lübeck
Amira Bajrovic, Department of Radiation Oncology, University Medical Center Eppendorf
Johann H Karstens, Department of Radiation Oncology, Hannover Medical School
Tobias Bartscht, Department of Hematology and Medical Oncology, University of Lübeck
Published
2015-02-11
How to Cite
Rades, D., Huttenlocher, S., Bajrovic, A., Karstens, J. H., & Bartscht, T. (2015). A new instrument for estimating the survival of patients with metastatic epidural spinal cord compression from esophageal cancer. Radiology and Oncology, 49(1). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/2182
Section
Clinical oncology