Direct Decompressive Surgery and Radiation Therapy Improved Walking Ability in Metastatic Epidural Spinal Cord Compression

2006 ◽  
Vol 88 (5) ◽  
pp. 1169 ◽  
Author(s):  
Esmé Finlay ◽  
Diaa Osman

Metastatic epidural spinal cord compression (MESCC) is a potentially disabling complication associated with advanced cancer. To address whether decompressive surgery followed by radiation therapy is superior to radiation therapy alone, this multi-institutional randomized trial compared outcomes among 101 patients with MESCCC. The study assessed functional outcomes such as ability to ambulate posttreatment, length of ambulation and maintained continence posttreatment, survival time after intervention, and additional functional, quality of life, and medication use outcomes. The practice-changing results of this study indicate that patients who received decompressive surgery and radiation had a longer length of posttreatment ambulation (122 days vs. 13 days, P = 0.03), better overall survival (126 days vs. 100 days, Relative risk 0.60, P = 0.033), lower doses of palliative medications, as well as better performance on several other secondary outcomes. From this landmark study, in appropriately selected patients with MESCC, surgery followed by radiation has become the standard of care.


Spine ◽  
2016 ◽  
Vol 41 (18) ◽  
pp. 1469-1476 ◽  
Author(s):  
Mingxing Lei ◽  
Jianjie Li ◽  
Yaosheng Liu ◽  
Weigang Jiang ◽  
Shubin Liu ◽  
...  

2020 ◽  
Vol 106 (4) ◽  
pp. 780-789 ◽  
Author(s):  
Dirk Rades ◽  
Jon Cacicedo ◽  
Antonio J. Conde-Moreno ◽  
Barbara Segedin ◽  
Jasna But-Hadzic ◽  
...  

2018 ◽  
Vol 115 ◽  
pp. e681-e687 ◽  
Author(s):  
Federico Pessina ◽  
Pierina Navarria ◽  
Giulio Alberto Carta ◽  
Giuseppe Roberto D'Agostino ◽  
Elena Clerici ◽  
...  

2020 ◽  
Vol 9 (4) ◽  
pp. 1370-1374
Author(s):  
James E. Han ◽  
Robert H. Press ◽  
Shaakir Hasan ◽  
J. Isabelle Choi ◽  
Charles B. Simone II

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