Validation of a scoring system predicting survival and function outcome in patients with metastatic epidural spinal cord compression (MESCC): a prospective and multicenter study

This prospective and multicenter study aims to validate a scoring system which were developed based on a retrospective date set consisting of 206 patients. It can guild surgeons to select the appropriate treatments for patients with MESCC. In this study, we prospectively analyzed 86 patients with MESCC from three hospitals. Those patients were divided into the same three prognostic groups according to our previous scoring system. Kaplan-Meier method and log-rank test were used to compare the survival prognosis in the three groups. ROC curves were performed to estimate the accuracy and c-statistic of the scoring model and the Tomita scoring model. This study was registered at Chinese Clinical Trial Registry (ChiCTR-POC-16008393). The median survival time was 3.9 months for patients with 0-2 points, 6.7 months for those with 3-5 points, and 12 months for those with 6-9 points, respectively (P<0.01). The corresponding postoperative ambulatory rates were 55.6%, 73.5%, and 94.1%, respectively (P<0.01). The ROC curve c-statistics for the scores as a predictor of 3, 6, and 12 months survival rates were 0.75, 0.74, and 0.70, respectively. The corresponding ROC curve c-statistics for the Tomita scores were 0.70, 0.68, and 0.66, respectively. This scoring system should be considered valid and reproducible to estimate the survival prognosis and functional outcome. This scoring model can help select the optimal therapy for patients with MESCC, and its capability to predict survival prognosis was relatively better than the Tomita scoring system.