{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:21:31Z","timestamp":1779290491401,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T00:00:00Z","timestamp":1530748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>This study was designed to identify preoperative predictors of survival in surgically treated patients with metastatic epidural spinal cord compression (MESCC), to examine how these predictors are related to 8 prognostic models, and to perform the first full external validation of these models in accordance with the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      One hundred forty\u2010two surgically treated patients with MESCC were enrolled in a prospective, multicenter North American cohort study and were followed for 12 months or until death. Cox regression was used. Noncollinear predictors with\u2009&lt;\u200910% missing data, with\u2009\u2265\u200910 events per stratum, and with\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05 in a univariate analysis were tested through a backward stepwise selection. For the original and revised Tokuhashi prognostic scoring systems (PSSs), Tomita PSS, modified Bauer PSS, van der Linden PSS, Bartels model, Oswestry Spinal Risk Index, and Bollen PSS, this study examined calibration graphically, discrimination with Harrell c\u2010statistics, and survival stratified by risk groups with the Kaplan\u2010Meier method and log\u2010rank test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The following were significant in the univariate analysis: type of primary tumor, sex, organ metastasis, body mass index, preoperative radiotherapy to MESCC, physical component (PC) of the 36\u2010Item Short Form Health Survey, version 2 (SF\u201036v2), and EuroQol 5\u2010Dimension (EQ\u20105D) Questionnaire. Breast, prostate and thyroid primary tumor (HR: 2.9;\n                      <jats:italic>P<\/jats:italic>\n                      =.0005), presence of organ metastasis (hazard ratio (HR): 2.0;\n                      <jats:italic>P<\/jats:italic>\n                      = .005) and SF\u201036v2 PC (HR: 0.95;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) were associated with survival in multivariable analysis. Predicted prognoses poorly matched observed values on calibration plots; Bartels model calibration slope was 0.45. Bollen PSS (0.61; 95% CI: 0.58\u20100.64) and Bartels model (0.68; 95% CI: 0.65\u20100.71) had the lowest and highest c\u2010statistics, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The primary tumor type (breast, prostate, or thyroid), an absence of organ metastasis, and a lower degree of physical disability are preoperative predictors of longer survival for surgical MESCC patients. These results are in keeping with current models. This full external validation of 8 prognostic PSSs or model of survival in surgical MESCC patients has revealed that calibration is poor, especially for long\u2010term survivors, whereas discrimination is possibly helpful.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31585","type":"journal-article","created":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T10:59:26Z","timestamp":1530788366000},"page":"3536-3550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Predictive factors of survival in a surgical series of metastatic epidural spinal cord compression and complete external validation of 8 multivariate models of survival in a prospective North American multicenter study"],"prefix":"10.1002","volume":"124","author":[{"given":"Anick","family":"Nater","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Toronto Western Hospital, University Health Network University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay A.","family":"Tetreault","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Toronto Western Hospital, University Health Network University of Toronto Toronto Ontario Canada"},{"name":"Graduate Entry Medicine University College Cork Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branko","family":"Kopjar","sequence":"additional","affiliation":[{"name":"Department of Health Services, University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Kansas Kansas City Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark B.","family":"Dekutoski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, CORE Institute Sun City West Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel A.","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sunnybrook Health Sciences Center Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles G.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of British Columbia Vancouver British Columbia Canada"},{"name":"Department of Orthopaedic Surgery, Vancouver Coastal Health Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"France","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, West Virginia University Morgantown West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren 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