Introduction: Studies have provided evidence that in selected patients combined surgery and radiotherapy provides the optimal neurological recovery in MESCC patients. However, patients with MESCC have relatively short life-expectancy and face numerous health challenges. The impact of surgery on improving quality of life outcomes in the setting of MESCC is unknown
Methods: 88 surgical patients were enrolled in a prospective multi-center, cohort study involving 8 sites in North America. Outcomes were assessed using the pain assessments, ASIA scale, SF-36v2, and EQ-5D.
Results: Average age was 58.1 years, 61 percent were males. Common primary sites were lungs (31 percent), prostate (15 percent), breast (15 percent), and kidney (12 percent). 68 percent survived three months, only 47 percent survived 12 months. The survival was associated with site of primary cancer. In survivors, the average improvement at 3 month was for .29 for EQ5D (P < .001), 27 for ODI (P < .001), 2.7 for VAS Pain (P < .05). Also, there was a significant improvement in ASIA Impairment grade (P < .05). The changes in SF36 PCS and MCS were not significant.
Conclusions: Surgically treated patients with MESCC are a diverse group of patients with different prognoses. The surviving patients experience clinically relevant symptoms improvement and gains in function and utility. Individuals with less than three month life expectancy may be less than ideal candidates for surgical intervention.
Patient Care: By providing treatment efficacy information to assist in medical decision making for individual patients and for creating health policy decisions
Learning Objectives: To improve knowledge of outcomes of surgical treatment of epidural metastatic spinal cord compression in different types of patients.