A Prognostic Instrument to Estimate the Survival of Elderly Patients Irradiated for Metastatic Epidural Spinal Cord Compression From Lung Cancer

Dirk Rades, Antonio J. Conde-Moreno, Barbara Segedin, Theo Veninga, Jon Cacicedo, Steven E. Schild

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Elderly patients with lung cancer need personalized treatment in palliative situations such as metastatic epidural spinal cord compression (MESCC). It is crucial to know a patient's survival prognosis to be able to provide optimal and individualized care. Therefore, a prognostic instrument enabling physicians to estimate a patient's survival time is required. We created such an instrument in the present study. Patients and Methods: The data from 201 elderly patients with lung cancer irradiated for MESCC were retrospectively evaluated. The radiation regimen used plus 10 factors were analyzed for associations with survival, including age, gender, histologic features, performance status, interval from lung cancer diagnosis until irradiation of MESCC, interval to developing motor weakness before irradiation, number of affected vertebrae, visceral metastases, other bone metastases, and the ability to walk before irradiation. The factors significant on multivariate analysis were included in the predictive instrument. The factor scores were obtained by dividing the 6-month survival rate by 10, and the patient scores were determined from the sum of the factor scores. Results: Performance status (P = .003), interval to developing motor weakness (P = .006), visceral metastases (P <.001), and the ability to walk (P = .002) were associated with survival. Taking into account the 6-month survival rates of these factors, the patient scores ranged from 5 to 19 points. Thus, 4 groups were designated: those with 5 to 10 points (n = 95), 11 to 13 points (n = 46), 14 to 16 points (n = 33), and 18 to 19 points (n = 27). The corresponding 6-month survival rates were 4%, 26%, 58%, and 81% (P <.001). The corresponding median survival times were 2, 4, 7, and 10 months. Conclusion: This new instrument will enable physicians to predict the survival prognosis of elderly patients with lung cancer-related MESCC, facilitating individualized treatment care.

Original languageEnglish (US)
JournalClinical Lung Cancer
DOIs
StateAccepted/In press - Aug 10 2015

Fingerprint

Spinal Cord Compression
Lung Neoplasms
Survival
Survival Rate
Neoplasm Metastasis
Physicians
Palliative Care
Spine
Multivariate Analysis
Radiation
Bone and Bones

Keywords

  • Elderly patients
  • Lung cancer
  • Metastatic epidural spinal cord compression
  • Prognostic factors
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

A Prognostic Instrument to Estimate the Survival of Elderly Patients Irradiated for Metastatic Epidural Spinal Cord Compression From Lung Cancer. / Rades, Dirk; Conde-Moreno, Antonio J.; Segedin, Barbara; Veninga, Theo; Cacicedo, Jon; Schild, Steven E.

In: Clinical Lung Cancer, 10.08.2015.

Research output: Contribution to journalArticle

Rades, Dirk ; Conde-Moreno, Antonio J. ; Segedin, Barbara ; Veninga, Theo ; Cacicedo, Jon ; Schild, Steven E. / A Prognostic Instrument to Estimate the Survival of Elderly Patients Irradiated for Metastatic Epidural Spinal Cord Compression From Lung Cancer. In: Clinical Lung Cancer. 2015.
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abstract = "Background: Elderly patients with lung cancer need personalized treatment in palliative situations such as metastatic epidural spinal cord compression (MESCC). It is crucial to know a patient's survival prognosis to be able to provide optimal and individualized care. Therefore, a prognostic instrument enabling physicians to estimate a patient's survival time is required. We created such an instrument in the present study. Patients and Methods: The data from 201 elderly patients with lung cancer irradiated for MESCC were retrospectively evaluated. The radiation regimen used plus 10 factors were analyzed for associations with survival, including age, gender, histologic features, performance status, interval from lung cancer diagnosis until irradiation of MESCC, interval to developing motor weakness before irradiation, number of affected vertebrae, visceral metastases, other bone metastases, and the ability to walk before irradiation. The factors significant on multivariate analysis were included in the predictive instrument. The factor scores were obtained by dividing the 6-month survival rate by 10, and the patient scores were determined from the sum of the factor scores. Results: Performance status (P = .003), interval to developing motor weakness (P = .006), visceral metastases (P <.001), and the ability to walk (P = .002) were associated with survival. Taking into account the 6-month survival rates of these factors, the patient scores ranged from 5 to 19 points. Thus, 4 groups were designated: those with 5 to 10 points (n = 95), 11 to 13 points (n = 46), 14 to 16 points (n = 33), and 18 to 19 points (n = 27). The corresponding 6-month survival rates were 4{\%}, 26{\%}, 58{\%}, and 81{\%} (P <.001). The corresponding median survival times were 2, 4, 7, and 10 months. Conclusion: This new instrument will enable physicians to predict the survival prognosis of elderly patients with lung cancer-related MESCC, facilitating individualized treatment care.",
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AU - Veninga, Theo

AU - Cacicedo, Jon

AU - Schild, Steven E.

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N2 - Background: Elderly patients with lung cancer need personalized treatment in palliative situations such as metastatic epidural spinal cord compression (MESCC). It is crucial to know a patient's survival prognosis to be able to provide optimal and individualized care. Therefore, a prognostic instrument enabling physicians to estimate a patient's survival time is required. We created such an instrument in the present study. Patients and Methods: The data from 201 elderly patients with lung cancer irradiated for MESCC were retrospectively evaluated. The radiation regimen used plus 10 factors were analyzed for associations with survival, including age, gender, histologic features, performance status, interval from lung cancer diagnosis until irradiation of MESCC, interval to developing motor weakness before irradiation, number of affected vertebrae, visceral metastases, other bone metastases, and the ability to walk before irradiation. The factors significant on multivariate analysis were included in the predictive instrument. The factor scores were obtained by dividing the 6-month survival rate by 10, and the patient scores were determined from the sum of the factor scores. Results: Performance status (P = .003), interval to developing motor weakness (P = .006), visceral metastases (P <.001), and the ability to walk (P = .002) were associated with survival. Taking into account the 6-month survival rates of these factors, the patient scores ranged from 5 to 19 points. Thus, 4 groups were designated: those with 5 to 10 points (n = 95), 11 to 13 points (n = 46), 14 to 16 points (n = 33), and 18 to 19 points (n = 27). The corresponding 6-month survival rates were 4%, 26%, 58%, and 81% (P <.001). The corresponding median survival times were 2, 4, 7, and 10 months. Conclusion: This new instrument will enable physicians to predict the survival prognosis of elderly patients with lung cancer-related MESCC, facilitating individualized treatment care.

AB - Background: Elderly patients with lung cancer need personalized treatment in palliative situations such as metastatic epidural spinal cord compression (MESCC). It is crucial to know a patient's survival prognosis to be able to provide optimal and individualized care. Therefore, a prognostic instrument enabling physicians to estimate a patient's survival time is required. We created such an instrument in the present study. Patients and Methods: The data from 201 elderly patients with lung cancer irradiated for MESCC were retrospectively evaluated. The radiation regimen used plus 10 factors were analyzed for associations with survival, including age, gender, histologic features, performance status, interval from lung cancer diagnosis until irradiation of MESCC, interval to developing motor weakness before irradiation, number of affected vertebrae, visceral metastases, other bone metastases, and the ability to walk before irradiation. The factors significant on multivariate analysis were included in the predictive instrument. The factor scores were obtained by dividing the 6-month survival rate by 10, and the patient scores were determined from the sum of the factor scores. Results: Performance status (P = .003), interval to developing motor weakness (P = .006), visceral metastases (P <.001), and the ability to walk (P = .002) were associated with survival. Taking into account the 6-month survival rates of these factors, the patient scores ranged from 5 to 19 points. Thus, 4 groups were designated: those with 5 to 10 points (n = 95), 11 to 13 points (n = 46), 14 to 16 points (n = 33), and 18 to 19 points (n = 27). The corresponding 6-month survival rates were 4%, 26%, 58%, and 81% (P <.001). The corresponding median survival times were 2, 4, 7, and 10 months. Conclusion: This new instrument will enable physicians to predict the survival prognosis of elderly patients with lung cancer-related MESCC, facilitating individualized treatment care.

KW - Elderly patients

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KW - Prognostic factors

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