Prognostic factors in patients with metastatic spinal cord compression secondary to lung cancer: a systematic review of the literature

Abstract

Purpose: The Metastatic spinal cord compression (MSCC) secondary to lung cancer (LC) has worse prognosis when compared to MSCC related to other solid tumors. The purpose of this study is to identify the survival time and the prognostic factors in the MSCC secondary to LC.

Methods: A systematic review of the literature has been carried out. Studies published between January 2005 and March 2015 were identified through the electronic database PubMed and LILACS. Two independent reviewers selected the articles.

Results: 7 studies were identified, which met the inclusion criteria, involving 1010 patients. The survival in 6 and 12 months ranged between 18 and 61%, and between 3.8 and 32%, respectively. The median survival ranged between 2.8 and 9 months. The variables related to the survival improvement were: female, performance status 1 or 2, pre-radiotherapy and postoperative ambulatory status, absence of bone metastases and visceral metastases, interval from cancer diagnosis to spinal metastases or radiotherapy of MSCC>15 months, slower (>7 days) development of motor deficit, and the neurological status at the postoperative.

Conclusions: The prognosis of the MSCC secondary to LC was poor. Considering the small number of studies identified, further research is needed to identify prognostic factors that are independent of the MSCC secondary to LC.

Keywords: Lung cancer; Metastatic spinal cord compression; Prognostic factors; Systematic review.