Article

OBJECTIVE: To evaluate the vital prognosis of patients with metastatic epidural
spinal cord compression (MESCC) to determine the relevance and duration of
physical medicine and rehabilitation (PM&R) admission. DATA SOURCES: Publications
from 1980 to January 2010 selected from 3 databases. STUDY SELECTION:
Publications reporting data correlated with survival and prognosis factors,
highlighting publications with level A scientific evidence (prospective
randomized controlled studies with significant casuistry and relevant judgment
criteria). The work focused on patients with MESCC below T1. DATA EXTRACTION:
Standardized reading grid. DATA SYNTHESIS: Thirty-eight studies met the inclusion
criteria. Most were retrospective. For survival rate at 1 year, they reported
data ranging from 12% to 58%. The 12-month and median survival rates were the
data reported most often in the articles. The median survival rate ranged from
2.4 to 30 months, and 12-month survival rates ranged from 12% to 58%. Of
publications that chose this parameter, 95% reported 12-month survival rates less
than 55.2% (95th percentile) regardless of patients' functional status and
associated risk factors (eg, location of primary cancer, metastases spreading,
pretreatment ambulatory status). CONCLUSIONS: Despite major progress in cancer
care, patients with MESCC still have a limited vital prognosis. The relevance and
duration of PM&R care must be evaluated against the patient's functional need for
rehabilitation while making time for family. The hypothesis of a 1-month stay
extended only once appears reasonable for patients to adapt to their new
functional status without taking precious time away from their loved ones.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS