CLO20-040: Factors Influencing Survival of Patients Treated for Spinal Metastases at a Regional Cancer Center in Appalachia

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  • a Joan C. Edwards School of Medicine, Marshall University, Huntington, WV
  • | b Hershel (Woody) Williams VA Medical Center, Huntington, WV

Background: Most patients with spinal metastases have limited survival. This study sought to analyze the factors associated with survival of patients treated for spinal metastases at our institution. Treatment modalities included steroids, radiation and/or surgery. Methods: We reviewed 181 charts of patients treated for spinal metastases between 2010 and 2018 from the Edwards Comprehensive Cancer Center in Huntington, WV. Out of these, 27 patients had spinal cord compression. Survival rate at 6 months was determined as the end point. Factors analyzed included age at treatment, gender, body mass index, smoking status, comorbidities, pain before and after treatment, accompanying brain metastasis, single versus multiple sites of vertebral metastases, time from symptoms to diagnosis, patient’s Eastern Cooperative Oncology Group (ECOG) score, initiation of steroids within 24 hours, surgical intervention, initiation of radiation within 30 days, paralysis at presentation, spinal cord compression, and types of cancer. All variables were compared using Chi Square (or Fisher’s exact) method. Stepwise logistic regression was used to determine significant variable association with mortality, which were included in the final multivariate model adjusted for gender and age. Results: Statistically significant factors associated with lower survival rate at 6 months included age greater than 60 (p=0.052), cancers such as melanoma and sarcoma (p=0.042), smoking (p=0.028), ECOG greater than 2(p=0.000), presence of spinal cord compression(p=0.012). The remainder of the factors listed in the methods did not meet statistical significance. (p>0.05). Conclusions: Awareness of factors associated with poor survival in our patient population with spinal metastases will be useful during discussions about patient expectations, treatment plans, and goals of care. We plan to compare our results with the existing literature.

Corresponding Author: Hassaan Raza Jafri, MD
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