Prognosis in patients with symptomatic metastatic spinal cord compression: survival in different cancer diagnosis in a cohort of 2321 patients.

Study Design. A retrospective cohort study of 2321 patients consecutively admitted to one center and diagnosed with acute symptoms of metastatic spinal cord compression (MSCC). Objective. To assess the possible change in 1-year survival for patients with MSCC from year 2005 through 2010 with respect to the primary cancer diagnosis. Summary of Background Data. An increasing number of patients are offered surgical treatment for MSCC. Among the reasons for this development are high evidence clinical studies, improved surgical techniques, and an increasing number of patients being treated for an oncological condition. Preoperative scoring systems are routinely used in the evaluation of these patients, and the primary oncological diagnosis is an important variable in all these systems. To our knowledge, no studies in a large group of patients have assessed the change in survival in these patients. This is of relevance because such changes in survival could have implications on the scoring systems used in the preoperative evaluation. Methods. All patients referred to the university hospital, Rigshospitalet, suspected of acute symptoms caused by spinal metastases and diagnosed with MSCC from January 1, 2005, to December 31, 2010, were included in a retrospective cohort, n = 2321. For all patients primary tumor, treatment, and 1-year survival was registered. Results. The overall 1-year survival did not change significantly from 2005 to 2010, but there was a significant increase in 1-year survival for the subgroups of patients with lung cancer hazard ratio = 0.93 (P= 0.008, 95% CI: 0.83–0.98) and renal cancer hazard ratio = 0.77 (P= 0.004, 95% CI: 0.56–0.92). Conclusion. Patients with MSCC from pulmonary and renal cancers experienced improved survival in the study period. No improvement was seen for patients with other oncological diagnoses. This corresponds to reports from oncological studies and could affect preoperative scoring systems. Conclusion. Level of Evidence: 3