Spinal cord compression of neoplastic origin: surgical experience using a common clinical language

• Oscar Godino ^[1] ; Ignacio Visus ^[2] ; Iago Garreta ^[1] ; Luis Lopez-Obarrio ^[1] ; Lluis González-Cañas ^[1] ; Juan José Sanchez ^[1] ; Mar Marin ^[2] ; Abelardo Montero ^[1] ; Hector Pérez ^[2] ; Leyre Asiaín ^[2] ; Arturo Navarro-Martin ^[2]
  1. [1] Hospital Universitari de Bellvitge

     Hospital Universitari de Bellvitge

     l'Hospitalet de Llobregat, España

     
  2. [2] Institute Catalá Oncología

     Institute Catalá Oncología

     Barcelona, España

     
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 10 (October), 2022, págs. 1932-1939
• Idioma: inglés
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• Resumen

  • Purpose To assess the value of a common clinical language in a multidisciplinary tumour board for spinal metastasis, using both the Rades score and the Spinal Instability Neoplastic Score (SINS) for multidisciplinary decision-making.

    Methods Retrospective study of 60 consecutive patients treated surgically for MSCC. The indication for surgery was done in a multidisciplinary board, basically according to SINS and RADES scores. Three prognostic groups were defined according to the Rades score: poor (Rades 1: 20–30 points), intermediate (Rades 2: 31–35), and good (Rades 3: 36–45).

    Results The 2-year overall survival (OS) rate was 50%, with median survival of 19 months. By Rades prognostic group (1, 2, 3), median OS was 6 months, 15 months, and not reached, respectively. OS rates at 6 months (Rades 1, 2, 3) were 51, 69, and 74.1%, respectively. Within the Rades 1 group, 6-month survival in patients with new-onset cancer was 68 vs. 40% in those with a known primary. The overall complication rate ≥ grade 3 was 23.3% (n = 14). In patients who underwent urgent surgery (< 48 h), the complication rate was 45.5% (5/11) versus 18.3% (9/49) in the planned surgeries.

    Conclusions Our findings supports the utility of using a common language in multidisciplinary tumour board for spinal metastasis. The 2-year OS rate in this series was 50%, which is the highest OS reported to date in this population. In the poor prognosis subgroup (Rades 1), OS at 6 months was higher in patients with new-onset cancer versus those with a known primary (68 vs. 40%). These findings suggest that surgery should be the first treatment option in patients with MSCC as first symptom of cancer although a predicted poor prognosis.