Survival analysis of 459 adult patients with primary spinal cancer in England and Wales: a population-based study

Background: Primary spinal gliomas are rare. Because data from the Cancer Registry of England and Wales covered larger numbers of patients and longer durations of follow-up, our objective was to define prognostic factors for survival at a national population level. Methods: From 1971 to 1995, data on 459 adult patients (age, > 15 years) with primary spinal cancer from the Cancer Registry of England and Wales were analyzed. Median survival and CSRs with respect to 7 variables (age, sex, morphology, WHO grade, socioeconomic status, geographic region, and period of diagnosis) were calculated using the Kaplan-Meier method. Cox regression was performed for estimating HRs for death. Results: The median survival and the 1-, 5-, and 10-year CSRs for the population were 10.2 years, 78.7%, 59.7%, and 50.5%, respectively. Univariate analysis revealed that age at diagnosis, morphology, WHO grade, and period of diagnosis affected the CSR. Multivariate analysis demonstrated 3 factors influencing survival: older age (ic, > 60 years; HR = 2.67; P < .001), non-ependymomas (HR 3.5 1; P < .001), and high-grade tumors (HR, = 3.01; P < .001). The improved survival in recent periods was associated with an increased number of diagnosed ependymomas. Conclusion: This study identifies old age, non-ependymomas, and high-grade tumors as negative prognostic factors for patient survival. The results from this population-based study are very helpful for comparison with those of other hospital-based studies and for public health purposes. (c) 2007 Elsevier Inc. All rights reserved.