Please login to view this media
- Talk
- 22/09/2022
- UK
External Validation of the New England Spinal Metastatic Score (NESMS) - A Pilot Feasibility Study for 12-Month Survival in Patients with Metastatic Spinal Cord Compression
Description
In this presentation, William Giles from the University of Sheffield discusses the external validation of the New England Spinal Metastatic Score (NESMS) and its implications for clinical practice. He highlights the increasing prevalence of spinal metastases in cancer patients due to advancements in treatments, but also underscores the concerning 30-day mortality rate of around 10%. Giles critiques previous prognostic scores for their lack of predictive power and introduces NESMS as a potentially improved alternative based on internal validation studies.
He explains that NESMS has not been externally validated in a UK population, leading his team to investigate its predictive ability through retrospective analysis of patients with spinal metastatic cord compression identified in the British spine registry from January 2019 to December 2020. They applied NESMS to 75 patients, noting its scoring system and how higher scores correlate with decreased mortality risk. The outcomes measured were mortality at three, six, and twelve months, with twelve-month mortality being the primary focus.
Giles presents data showing that the distribution of NESMS scores in their population demonstrates expected patterns with significant variations in mortality rates compared to Schoenfeld et al.'s original findings. It was noted that higher mortality rates were observed in his group, particularly among those with the best prognostic scores, possibly due to differences in population demographics and systematic biases in care.
He concludes with an emphasis on the need for clarity in NESMS criteria and calls for further studies to explore its applicability and accuracy. While suggesting that NESMS holds promise as a prognostic tool, Giles urges caution in its incorporation into clinical practice until its efficacy can be thoroughly confirmed.