Korean J Urol.  2009 Dec;50(12):1174-1181.

Analysis of Clinical Features of Patients with Metastatic Spinal Cord Compression Caused by Prostate Cancer

• Hong S
• You D
• Jeong IG
• Hong JH
• Ahn H
• Kim CS

Abstract

PURPOSE
The purpose of this study was to investigate the clinical presentation and outcomes of metastatic spinal cord compression (MSCC) caused by prostate cancer (PCa) and to determine the prognostic factors for relieving the symptoms of MSCC.
MATERIALS AND METHODS
A total of 52 patients (47 who underwent radiotherapy and 5 who underwent surgery) treated between 1989 and 2007 were included. We investigated potential prognostic factors for the improvement of symptoms caused by MSCC. Multivariate Cox proportional hazards regression was used to determine the independent significant factors for disease-specific survival (DSS).
RESULTS
Twenty-four (51.1%) of 47 patients and 3 (60%) of 5 patients showed symptom improvement after radiotherapy or surgery, respectively. The number of involved vertebrae (1 or 2) as well as ambulatory and Eastern Cooperative Oncology Group performance status (ECOG PS, 1 or 2) before radiotherapy or surgery were significant predictors of improvement of symptoms caused by MSCC (p=0.024, p=0.001, and p=0.001, respectively). In the multivariate analysis, hemoglobin (> or =11.1), the number of involved vertebrae (1 or 2), and ECOG PS (1 or 2) remained significant predictors (p=0.021, p=0.033, and p=0.034, respectively). On the Kaplan-Meier curve, however, only ECOG PS (1 or 2) was a significant factor predicting DSS (p=0.014).
CONCLUSIONS
In our study, improvement of symptoms after treatment was observed in half of the MSCC patients; however, there were no factors predicting symptom improvement other than the number of involved vertebrae and the patients' ambulatory and performance status at the time of treatment. Patients with ECOG PS 1 or 2 may therefore be expected to have good DSS after radiotherapy or surgery.

Keyword

Prostatic neoplasms; Spinal cord compression; Radiotherapy; Survival rate

MeSH Terms

Hemoglobins
Humans
Multivariate Analysis
Prostate
Prostatic Neoplasms
Spinal Cord
Spinal Cord Compression
Spine
Survival Rate
Hemoglobins

Figure

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  Fig. 1 Kaplan-Meier survival curves according to ECOG performance status. There was a significant difference between the ECOG performance status 1 or 2 group and the 3 or 4 group (p=0.014). ECOG: Eastern Cooperative Oncology Group.

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