Introduction: The aim of this study was to ascertain the key preoperative predictive factors of survival, neurological, functional and quality of life outcomes in patients with metastatic epidural spinal cord compression (MESCC) treated with surgery.
Methods: Multiple electronic databases were searched from January 1st, 1990 to August 31st, 2015 to identify cohort studies using multiple regression analyses to assess predictors of survival, neurological, functional, and quality of life outcomes in surgical adult MESCC patients. Suitable articles were critically appraised. The strength of the overall body of evidence with respect to each predictor was evaluated using a method that included the GRADE approach.
Results: Of the 6078 citations identified, 16 were included, all of which evaluated predictors of survival. Only one study was rated Class II; all other were Class III. There is moderate evidence that a poor Karnofsky Performance Status (KPS), a low serum albumin level, the presence of metastasis to vital organs, an impaired ambulatory and neurological status have a negative impact on survival. Based on low evidence, other preoperative factors such as gender and race are not important predictors of survival in surgically treated MESCC patients.
Conclusions: Although there was a wide variability in both the type and categorization of preoperative predictors across studies, the current review suggests that several preoperative factors such as a poor KPS and the presence of metastasis to vital organs have a negative impact on survival in surgical MESCC patients while others, like gender or race, do not.
Patient Care: It will inform physicians on the key predictive factors related to survival, neurological, functional, and health related quality of life in patients with metastatic epidural spinal cord compression who underwent surgical treatment
Learning Objectives: Identify preoperative factors of survival, neurological, functional and health related quality of life in patients with metastatic epidural spinal cord compression who underwent surgical treatment.