Forecasting Survival Probabilities After Radiotherapy of Metastatic Epidural Spinal Cord Compression from Colorectal Cancer in the Elderly

Abstract

Aim: To develop a tool forecasting survival of elderly patients with metastatic epidural spinal cord compression (MESCC) from colorectal cancer (CRC).

Patients and methods: Fifty-seven patients were retrospectively evaluated. Eleven characteristics were investigated for survival. Independent characteristics were used for the tool. Scores were obtained from dividing 6-month survival rates by 10. From summing these points, patient scores were obtained.

Results: On survival analysis (Cox regression model), organ metastases (p=0.006), performance status (p<0.001), pre-radiotherapy walking ability (p<0.001) and the dynamic of developing motor weakness (p=0.033) were significant factors affecting survival and were incorporated into the tool. Possible patient scores were 5, 9, 10, 13, 14, 16, 20 or 24 points. Three groups were created with scores of 5-10, 13-16 and 20-24 points, with 6-month survival rates of 4%, 23% and 79%, respectively (p<0.001).

Conclusion: By applying this tool, it is possible to forecast the survival of elderly patients experiencing MESCC from CRC, which is important for optimal treatment personalization.

Keywords: Colorectal cancer; elderly; metastatic epidural spinal cord compression; radiotherapy; survival forecast.