• Yu Tang, Jintao Qu, Juan Wu, Song Li, Yue Zhou, and Jianru Xiao.
• Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, No. 2, Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China. E-mail address for Y. Zhou: happyzhou@vip.163.com.
• J Bone Joint Surg Am. 2015 Sep 2; 97 (17): 1418-25.

BackgroundMetastatic spinal cord compression is a disastrous consequence of non-small-cell lung cancer (NSCLC). There have been few studies of the outcomes or prognostic factors in patients with metastatic spinal cord compression from NSCLC treated with surgery and adjuvant therapies.MethodsFrom 2002 to 2013, 116 patients with metastatic spinal cord compression from NSCLC treated with surgery and adjuvant therapies were enrolled in this retrospective analysis. Kaplan-Meier methods and Cox regression analysis were used to estimate overall survival and identify prognostic factors for survival.ResultsMultivariate analysis suggested that the Eastern Cooperative Oncology Group performance status (ECOG-PS), preoperative and postoperative Frankel scores, postoperative adjuvant radiation therapy, and target therapy were independent prognostic factors. Ninety patients died at a median of twelve months (range, three to forty-seven months) postoperatively, and twenty-six patients were still alive at the time of final follow-up (at a median of fifteen months [range, five to fifty-four months]).ConclusionsThe complete disappearance of deficits in spinal cord function after surgery was the most robust predictor of survival. Adjuvant radiation therapy and target therapy were also associated with a better prognosis.Level Of EvidencePrognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

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