Prognostic Factors Influencing Survival Rate of Patients Operated for Prostate-Related Metastatic Spinal Cord Compression (MSCC).

Abstract

Prostate-related metastatic spinal cord compression (MSCC) accounts for 50% of all MSCC cases and constitute an oncological emergency. Metastatic spread has a detrimental impact on patient quality of life and the whole management strategy. We sought to identify the prognostic factors influencing the survival rate of patients operated for prostate-related MSCC. Sixty medical records of patients operated for prostate-related MSCC were selected from January 2002 to December 2014 in the Neurosurgery Department, Yopougon Teaching Hospital, Abidjan, Ivory Coast. Tokuhashi and Karnofsky scales were used to assess prognostic scores. Survival curves were generated using the Kaplan-Meier, and we used the log rank analysis for statistical comparison with a statistical significance threshold p < 0.05. The mean age was 57.16 ± 9.3years (41-80) with an average of 57years. The mean survival of the population was 27 ± 5months (1-55months), and the overall survival curve showed that 50% survival rate was seen in 31months. The following parameters were associated with a poor overall survival rate: Tokuhashi score between 0 and 8 and Karnofsky score ≤ 50%. Poor overall survival rate was also observed in patient over 60years of age, WHO score > 3, Frankel scale A-B, presence of metastasis, Gleason score > 5, PSA levels > 100ng/ml, LH-RH analogue (decapeptyl LP 11.25) and anterior corpectomy and fusion. All analysis failed to show any significant difference. The management of prostate-related MSCC requires a multidisciplinary approach. Surgery has an unequivocal impact on patient quality of life if their combined prognostic scores are satisfactory.