Metastatic epidural spinal cord compression. Results of treatment and survival

Sørensen, Per Soelberg; Børgesen, S. E.; Rohde, Karen; Rasmusson, Bente; Bach, Flemming W.; Bøge-Rasmussen, Torben; Stjernholm, Pia; Larsen, Bo; Agerlin, Niels; Gjerris, F.

doi:10.1002/1097-0142(19900401)65:7<1502::aid-cncr2820650709>3.0.co;2-d

Cited by 204 publications

(86 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…and of the ambulatory status before radiotherapy have been previously described for the first course of RT for MSCC. 12,[20][21][22][23] The time to development of motor deficits before radiotherapy is also associated with motor function. 12,24 A slower development of motor deficits (>14 days) represents a slower growing lesion.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Rades

Rudat

Veninga

et al. 2008

Cancer

View full text Add to dashboard Cite

Objective: We examined whether glucose transporter 1 (GLUT1) deficiency causes common idiopathic generalized epilepsies (IGEs). Methods: The IGEs are common, heritable epilepsies that usually follow complex inheritance; currently little is known about their genetic architecture. Previously considered rare, GLUT1 deficiency, due to mutations in SLC2A1, leads to failure of glucose transport across the blood–brain barrier and inadequate glucose for brain metabolism. GLUT1 deficiency was first associated with an encephalopathy and more recently found in rare dominant families with epilepsy and paroxysmal exertional dyskinesia (PED). Five hundred four probands with IGEs and 470 controls underwent SLC2A1 sequencing. Glucose transport was assayed following expression of SLC2A1 variants in Xenopus oocytes. All available relatives were phenotyped, and SLC2A1 was sequenced. Results: Functionally validated mutations in SLC2A1 were present in 7 of 504 (1.4%) probands and 0 of 470 controls. PED, undiagnosed prior to study, occurred in 1 proband and 3 of 13 relatives with mutations. The IGEs in probands and relatives were indistinguishable from typical IGE. Three cases (0.6%) had mutations of large functional effect and showed autosomal dominant inheritance or were de novo. Four (0.8%) cases had a subtle functional effect; 2 showed possible dominant inheritance, and 2 did not. These alleles leading to subtle functional impairment may contribute to complex, polygenic inheritance of IGE. Interpretation: SLC2A1 mutations contribute to approximately 1% of IGE both as a dominant gene and as a susceptibility allele in complex inheritance. Diagnosis of GLUT1 deficiency has important treatment (ketogenic diet) and genetic counseling implications. The mechanism of restricted glucose delivery differs from the current focus on IGEs as ion channel disorders. ANN NEUROL 2012;72:807–815

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Rades

Rudat

Veninga

et al. 2008

Cancer

View full text Add to dashboard Cite

show abstract

“…Earlier studies perhaps until the mid-1980s collectively showed that decompressive laminectomy alone did not offer any additional benefit compared to conventional radiotherapy [5][6][7][8]. Then evolved a trend towards posterior decompression combined with stabilisation surgery resulting in improved outcome and survival [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effect of timing of surgery on neurological outcome and survival in metastatic spinal cord compression

et al. 2012

View full text Add to dashboard Cite

Purpose Metastatic spinal cord compression (MSCC) requires expeditious treatment. While there is no ambiguity in the literature about the urgency of care for patients with MSCC, the effect of timing of surgical intervention has not been investigated in detail. The objective of our study was to investigate whether or not the 'timing of surgery' is an important factor in survival and neurological outcome in patients with MSCC. Methods All patients with MSCC presenting to our unit from October 2005 to March 2010 were included in this study. Patients were divided into three groups-those who underwent surgery within 24 h (Group 1, n = 45), between 24 and 48 h (Group 2, n = 23) and after 48 h (Group 3, n = 53) from acute presentation of neurological symptoms. The outcome measures studied were neurological outcome (change in Frankel grade post-operatively), survival (survival rate and median survival in days), incidence of infection, length of stay and complications. Results Patients' age, gender, revised Tokuhashi score, level of spinal metastasis and primary tumour type were not significantly different between the three groups. Greatest improvement in neurology was observed in Group 1, although not significantly when compared against Group 2 (24-48 h; (p = 0.09). When comparisons of neurological outcome were performed for all patients having surgery within 48 h (Groups 1 and 2) versus after 48 h (Group 3), the Frankel grade improvement was significant (p = 0.048) favouring surgery within 48 h of presentation. There was a negative correlation (-0.17) between the delay in surgery and the immediate neurological improvement, suggesting less improvement in those who had delayed surgery. There was no difference in length of hospital stay, incidence of infection, post-operative complications or survival between the groups. Conclusions Our results show that surgery should be performed sooner rather than later. Furthermore, earlier surgical treatment within 48 h in patients with MSCC resulted in significantly better neurological outcome. However, the timing of surgery did not influence length of hospital stay, complication rate or patient survival.

show abstract

“…The life expectancy of most MSCC patients is quite short, with reported median survival ranging between 2 and 6 months 10,14,20) . In long-term survivors, local control of MSCC becomes important.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Survival and Ambulatory Outcome in Metastatic Spinal Tumors : Prognostic Factor Analysis

Moon

Chung

Jahng

et al. 2011

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

show abstract

Metastatic epidural spinal cord compression. Results of treatment and survival

Cited by 204 publications

References 22 publications

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Prognostic factors for functional outcome and survival after reirradiation for in‐field recurrences of metastatic spinal cord compression

Effect of timing of surgery on neurological outcome and survival in metastatic spinal cord compression

Postoperative Survival and Ambulatory Outcome in Metastatic Spinal Tumors : Prognostic Factor Analysis

Contact Info

Product

Resources

About