Prognostic Factors in Patients with Metastatic Spinal Cord Compression Secondary to Lung Cancer-A Retrospective UK Single-Centre Study.

Autor: Vassiliou A; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Osunronbi T; Hull University Teaching Hospital NHS Foundation Trust, Hull HU1 3SA, UK., Enyioma S; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Rago G; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Karathanasi A; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Ghose A; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK.; Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.; Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London HA6 2RN, UK., Sheriff M; Department of Urology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Mikropoulos C; Department of Medical Oncology, St Luke's Cancer Centre, Royal Surrey Hospital, Guildford GU1 1EB, UK., Sanchez E; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK., Moschetta M; Novartis Institutes for BioMedical Research, CH-4056 Basel, Switzerland., Chargari C; Department of Radiation Oncology, Pitié Salpêtrière University Hospital, 75013 Paris, France., Rassy E; Department of Medical Oncology, Gustave Roussy Institut, 94805 Villejuif, France., Boussios S; Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK.; Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King's College London, London SE1 9RT, UK.; Kent Medway Medical School, University of Kent, Canterbury CT2 7LX, UK.; AELIA Organization, 9th Km Thessaloniki-Thermi, 57001 Thessaloniki, Greece.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Sep 06; Vol. 15 (18). Date of Electronic Publication: 2023 Sep 06.
DOI: 10.3390/cancers15184432
Abstrakt: Purpose: Metastatic spinal cord compression (MSCC) is a severe complication of cancer that can lead to irreversible neurological impairment, necessitating prompt recognition and intervention. This retrospective, single-centre study aimed to determine the prognostic factors and survival rates among patients presenting with MSCC secondary to lung cancer.
Methods and Materials: We identified 74 patients with epidural metastases-related spinal cord compression and a history of lung cancer through the electronic database of Medway Maritime Hospital in the United Kingdom (UK), spanning the period from April 2016 to September 2021. Among them, 39 were below 55 years old, while 35 were aged 55 years or older; 24 patients were diagnosed with small cell lung cancer (SCLC), and 50 patients had non-small cell lung cancer (NSCLC).
Results: The median overall survival (OS) was 5.5 months, with 52 out of 74 patients dying within 6 months of diagnosis with MSCC. For the entire cohort, the statistically significant variables on multi-variate analysis were cancer type (NSCLC had improved OS), the number of involved vertebrae (one to two vertebrae involvement had improved OS), and the time taken to develop motor deficits (≤10 days to develop motor deficits had worsened OS). For the NSCLC cohort, the statistically significant variables on multivariate analysis were molecular alterations (patients with epidermal growth factor receptor ( EGFR ) mutation), pre-treatment ambulatory status, Eastern Cooperative Oncology Group (ECOG) performance status, and the time taken to develop motor deficits.
Conclusions: Within the entire cohort, patients diagnosed with NSCLC and spinal metastases affecting one to two vertebrae exhibited enhanced OS. Within the NSCLC subgroup, those with EGFR mutations who were ambulatory and possessed an ECOG performance status of 1-2 demonstrated improved OS. In both the entire cohort and the NSCLC subgroup, the development of motor deficits within a period of ≤10 days was associated with poor OS.
Databáze: MEDLINE
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