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Retrospective Clinical Study |
Kaiser Permanente Medical Group, Department of Neurology, Baldwin Park, CA 91706 [M.C.C.]; and Department of Nursing, University of California, San Diego, San Diego, CA 92103 [P.A.K.]
1 Address correspondence and reprint requests to Marc C. Chamberlain, M.D., Kaiser Permanente Medical Group, Department of Neurology, 1011 Baldwin Park Boulevard, Baldwin Park, CA 91706.
Abstract
Epidural spinal cord compression (ESCC) is a common metastatic complication occurring in 5% of patients with cancer. We sought to determine retrospectively the frequency of multiple sites of ESCC at presentation and the risk of recurrence of ESCC. Of the cancer patients seen by the University of California San Diego's Neuro-Oncology Service between August 1986 and January 1997, 108 developed ESCC that was documented both clinically and by MRI of the spine. In 77 patients (71%), a single site of ESCC was seen; 31 patients (29%) had multiple sites of ESCC. All sites of ESCC were irradiated. In 7% of patients with single-site ESCC and in 9% of patients with multiple-site ESCC, the disease recurred. Length of survival was similar for patients with single- or multiple-site ESCC (median, 4.5 months) versus patients with recurrent ESCC (median, 7 months). An MRI of the entire spine in patients with suspected ESCC demonstrated multiple sites of ESCC in nearly one-third of patients. In 8% of patients with ESCC, symptomatic ESCC recurred.
References
Barron, K., Hirano, A., Araki, S., and Terry, A.D. (1959) Experiences with metatastatic neoplasms involving the spinal cord. Neurology 9, 91-106.
Black, P. (1979) Spinal metastases: Current status and recommended guidelines for management. Neurosurgery 5, 726-746.[ISI][Medline]
Boogerd, W., and van der Sande, J.J. (1993) Diagnosis and treatment of spinal cord compression and malignant disease. Cancer Treat. Rev. 19,129 -150.[CrossRef][ISI][Medline]
Chamberlain, M.C., Abitol, J.J., and Garfin, S.R. (1990) Epidural spinal cord compression: Treatment options. Semin. Spine Surg. 2,203 -209.
Gilbert, R.W., Kim, J.H., and Posner, J.B. (1978) Epidural spinal cord compression from metastatic tumor: Diagnosis and treatment. Ann. Neurol. 3, 40-51.[CrossRef][ISI][Medline]
Helwig-Larsen, S., Hansen, S.W., and Sorensen, P.S. (1995) Second occurrence of symptomatic metastastic spinal cord compression and findings of multiple spinal epidural metastases. Int. J. Radiat. Oncol. Biol. Phys. 33,595 -598.[CrossRef][Medline]
Kaminski, H.J., Diwan, V.G., and Ruff, R.L. (1991) Second occurrence of spinal epidural metastases. Neurology 41,744 -746.[Medline]
Rodichok, L.D., Ruckdeschel, J.C., Harper, G.R., Cooper, G., Prevosti, L., Fernando, L., and Baxter, D.H. (1986) Early detection and treatment of spinal epidural metastases: The role of myelography. Ann. Neurol. 20,696 -702.[CrossRef][Medline]
van der Sande, J.J., Kroger, R., and Boogerd, W. (1990) Multiple spinal epidural metastases; an unexpectedly frequent finding. J. Neurol. Neurosurg. Psychiatry 53,1001 -1003.[Abstract]
This article has been cited by other articles:
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  M. C. Chamberlain, A. Sloan, and F. Vrionis Systematic Review of the Diagnosis and Management of Malignant Extradural Spine Cord Compression: The Cancer Care Ontario Practice Guidelines Initiative's Neuro-Oncology Disease Site Group J. Clin. Oncol., October 20, 2005; 23(30): 7750 - 7751. [Full Text] [PDF]
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