Prognosis in Patients With Symptomatic Metastatic Spinal Cord Compression

Abstract

Patients with MSCC from pulmonary and renal cancers experienced improved survival in the study period. No improvement was seen for patients with other oncological diagnoses. This corresponds to reports from oncological studies and could affect preoperative scoring systems.

Long-term survivors after surgical management of metastatic spinal cord compression

“…This population corresponded to 28 % of our global population, underlining the potential positive evolution of the prognosis for MSCC patients. Recent reports have suggested a potential improvement in this prognosis, mainly for patients with lung or renal cancer [5], and such improvements could be explained by the refinement of surgical techniques, and by the improvement in the use of systemic therapy for these two tumor types [13,14]. In our series, breast cancer and hematological primaries, both known to display a high sensitivity to systemic treatments, represented more than 80 % of the long-term survival patients.…”

“…However, these scores were redundant and their validities were not confirmed [10,11], underlining the remaining crucial role of the use of multidisciplinary consultation. Simultaneously, long-term survival of MSCC patients has been suggested to increase, but to date no clear data have been reported on this issue [5]. Rades et al [12] evaluated patients surviving more than 1 year, but this analysis concerned only patients treated with conventional radiotherapy.…”

“…Surgery has been reported to improve the functional and neurological status of patients, as well as the pain resulting from MSCC [6,7]. However, the survival impact of this therapy remains controversial, and therapeutic indications remain a matter of debate [5]. Several predictive scores have been published to assist in making treatment decisions, and the most currently used are those established by Tokuhashi [8] and Tomita [9]; both recommended that treatment strategies should be based on survival prediction according to these tools' classifications.…”

“…Spinal surgery and spinal fixation techniques have improved with the development of multiple approaches, such as laminectomy (with or without fixation) and kyphoplasty. Accordingly, an increasing number of patients are offered surgical treatment for MSCC [5]. Surgery has been reported to improve the functional and neurological status of patients, as well as the pain resulting from MSCC [6,7].…”

Incidence, associated factors, and survival in metastatic spinal cord compression secondary to lung cancer

“…Rades et al [32,33] studied 356 cases of MSCC secondary to NSCLC between 1992 and 2010 and described survival times of 6 and 12 months at 28% and 14%, respectively; the median survival time was 4 months. Yet, Morgen et al [34] demonstrated that the survival time of 12 months in patients with MSCC secondary to LC revealed a statistically significant increase between 2005 and 2010, ranging from 4% to 19%. These recent results revealed an improvement in the prognosis of this population.…”