Clinical Flow and Outcomes in Patients with Malignant Spinal Cord Compression in Korea / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: We investigated the process from the development of symptoms to treatment and analyzed the clinical characteristics, treatment outcomes, and prognostic factors related to the treatment response and survival of patients with malignant spinal cord compression (SCC). METHODS: This study retrospectively reviewed the medical records of 56 patients diagnosed with metastatic SCC using magnetic resonance imaging (MRI) from January 2002 to December 2011. RESULTS: The median age of the patients was 59.5 years, and the most common origin of metastatic SCC was lung cancer. The median interval from symptom development to visiting the hospital was 7 days, and the median interval from admission to the date of clinical diagnosis was 0 days. The median interval from clinical diagnosis to the date of MRI or therapy was 1 or 4 days, respectively. Twenty-six patients (46.4%) had ambulation dysfunction at initial presentation, and 33 patients (61.1%) had ambulation dysfunction after radiotherapy or surgery. The rate of patients regaining walking ability was 17.6% with radiotherapy and 25% with surgery. In univariate analysis, good performance status, ambulatory function, and autonomic function before therapy were favorable predictors of ambulatory function after treatment in all patients. No significant factor was found in multivariate analysis. Median overall survival (OS) was 67 days, and the significant factors for survival by multivariate analysis were performance status and the presence of prostate cancer. CONCLUSIONS: The therapeutic response of ambulatory function and OS in malignant SCC is very poor. Multidisciplinary communication is required for the prompt and optimal management of patients with malignant SCC.