A new prognostic factor for the survival of patients with renal cell carcinoma developing metastatic spinal cord compression

Background and purpose. This study aimed to identify a potential association of the number of involved extraspinal organs with the survival of patients with metastatic spinal cord compression (MSCC) from renal cell carcinoma. Patients and methods. Data of 69 patients irradiated for MSCC from renal cell carcinoma were retrospectively evaluated for survival. The prognostic value of the number of involved extraspinal organs and eight additional factors were investigated. These additional factors included age, gender, performance status, number of involved vertebrae, interval from cancer diagnosis to radiotherapy (RT) of MSCC, ambulatory status prior to RT, time developing motor deficits, and the fractionation regimen (30 Gy in 10 fractions vs. higher doses). Results. The 6-month survival rates for involvement of 0, 1, and ≥2 extraspinal organs were 93, 57, and 21%, respectively (p<0.001). In the multivariate analysis, the number of involved extraspinal organs maintained significance (risk ratio 2.65; 95% confidence interval 1.64-4.52; p<0.001). The interval from cancer diagnosis to RT of MSCC (p=0.013) and ambulatory status prior to RT (p=0.002) were also independent predictors of survival. Conclusion. The number of involved extraspinal organs is a new prognostic factor of survival in patients with MSCC from renal cell carcinoma and should be considered in future clinical trials.