Age Affects Optimal Treatment for Spinal Metastases

Outcomes similar for surgery and radiation in elderly patients

WEDNESDAY, Mar. 11 (HealthDay News) -- Although surgery for spinal metastases is generally superior to radiation, the treatment giving the best outcome is strongly affected by age, researchers report in the Mar. 1 issue of Spine.

John H. Chi, M.D., from Harvard Medical School in Boston, and colleagues examined the effect of age on outcomes in 101 patients with malignant epidural spinal cord compression randomly assigned to surgery or radiation.

The investigators found that surgery was generally superior to radiation, but that surgery and radiation became more equal with increasing age. In patients 65 years of age or older, the two treatments produced similar outcomes. In patients younger than 65 years old, surgery was significantly better than radiation in preserving ambulation, the researchers report.

"Age is an important variable in predicting preservation of ambulation and survival for patients being treated for spinal metastases," Chi and colleagues conclude. "Our results provide compelling evidence for the first time that particular age cut points may help in selecting patients for surgical or non-surgical intervention based on outcome."

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