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 withEGFRmutations 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.
目的：转移性脊髓压迫（MSCC）是癌症的一种严重并发症，可导致不可逆的神经功能损伤，需要及时识别和干预。这项回顾性单中心研究旨在确定肺癌继发MSCC患者的预后因素和生存率。方法与材料：通过英国梅德韦海事医院的电子数据库，我们识别出2016年4月至2021年9月期间74例患有硬膜外转移相关脊髓压迫且有肺癌病史的患者。其中，39例年龄低于55岁，35例年龄为55岁或以上；24例患者被诊断为小细胞肺癌（SCLC），50例患者为非小细胞肺癌（NSCLC）。结果：中位总生存期（OS）为5.5个月，74例患者中有52例在诊断为MSCC后6个月内死亡。在整个队列中，多变量分析显示具有统计学显著性的变量包括：癌症类型（NSCLC患者OS改善）、受累椎体数量（1-2个椎体受累者OS改善）以及出现运动功能障碍的时间（≤10天内出现运动功能障碍者OS较差）。在NSCLC队列中，多变量分析显示具有统计学显著性的变量包括：分子改变（存在表皮生长因子受体（EGFR）突变的患者）、治疗前行走状态、东部肿瘤协作组（ECOG）体能状态以及出现运动功能障碍的时间。结论：在整个队列中，诊断为NSCLC且脊柱转移影响1-2个椎体的患者表现出更长的OS。在NSCLC亚组中，具有EGFR突变、能够行走且ECOG体能状态为1-2级的患者OS更佳。在整个队列和NSCLC亚组中，≤10天内出现运动功能障碍均与较差的OS相关。
肿瘤(癌症)患者之家