Multicentric prospective study.
Through this study, we aimed to clarify and update the prognostic assessment of elderly with spine metastasis (SpM).
Summary of Background Data.
The incidence SpM is rising, in parallel life expectancy is getting longer and the number of elderly patients presenting malignancy is increasing. Elderly patients with SpM constitute a growing heterogeneous population
The patient data used in this study was obtained from a French national multi-center database of patients treated for SpM between 2014–2017. Two hundred and forty-three consecutive patients over 70 years old were diagnosed.
Median overall survival (OS) time for elderly patients following the event of SpM was 16.3 months. First, we identified significantly worse survival prognostic factors for elderly patients with SpM: poor WHO status 3/4: [HR: 2.245, 95% CI 1.899–2.655; p < 0.0001], > 80 years [HR: 1.758, 95% CI 1.117–2.765; p = 0.015] no-ambulatory neurological status [Franckel A/B status [HR: 3.219, 95% CI 1.621–6.390; p < 0.0001], gastro-intestinal cancer [HR: 3.530, 95% CI 1.75–7.1; p < 0.0001], lung cancer [HR: 3.452, 95% CI 1.784–6.680; p < 0.0001], orthopedic brace treatment [HR: 1.329; 95% CI 1.050–1.683; p = 0.018] and epiduritis [HR: 1.52, 95% CI 1.041–2.22; p = 0.03] were independently poor prognostic factors of survival. The only good prognosis factor identified was thyroid cancer [HR: 0.257, 95% CI 0.07–0.952; p = 0.04].
Prognosis factors concerning the survival of elderly patients seem to be the same as those for the general population such as primary cancer histology, neurological status, WHO status and epiduritis. Age >80 y.o also appears to be an independently poor prognosis factor. Our data suggests that orthopaedic brace treatment is also associated with lower survival.
Level of Evidence: 2