Direct Decompressive Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Epidural Spinal Cord Compression: A Meta-analysis

  title={Direct Decompressive Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Epidural Spinal Cord Compression: A Meta-analysis},
  author={Chang-Hyun Lee and Ji-Woong Kwon and Jaebong Lee and Seung-Jae Hyun and Ki-Jeong Kim and Tae Ahn Jahng and Hyun-Jib Kim},
Study Design. A systemic review and meta-analysis. Objective. To compare the ambulatory status and survival for metastatic epidural spinal cord compression (MESCC) in patients treated with direct decompressive surgical resection (DDSR) followed by radiotherapy (RTx) with those in patients treated with RTx alone. Summary of Background Data. Surgical techniques have remarkably evolved from decompressive laminectomy without ventral tumor excision to DDSR, which has displayed favorable outcomes… 

Survival and Clinical Outcomes in Surgically Treated Patients With Metastatic Epidural Spinal Cord Compression: Results of the Prospective Multicenter AOSpine Study.

  • M. FehlingsA. Nater A. Vaccaro
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2016
Surgical intervention provides immediate and sustained improvement in pain, neurologic, functional, and HRQoL outcomes, with acceptable risks in patients with a focal symptomatic MESCC lesion who have at least a 3 month survival prognosis.

Metastatic spinal cord compression (MSCC) treated with palliative decompression: Surgical timing and survival rate

It is demonstrated that surgical timing has a significant impact on survival in MSCC patients treated with palliative decompression, and after motor deficit onset, survival can still be improved with surgery within 7 days.

Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

A new scoring system for predicting survival and function outcome of MSCC patients after surgical decompression and spine stabilization is presented and can help surgeons select the best candidates for surgical treatment.

The neurological outcome of radiotherapy versus surgery in patients with metastatic spinal cord compression presenting with myelopathy

Surgical decompression and stabilization may be required to improve the neurological function in patients with metastatic spinal cord compression presenting with myelopathy, however, the high rate of complications associated with surgery should be taken into consideration.

Surgical treatment indications and outcomes in patients with spinal metastases in the cervicothoracic junction (CTJ)

Surgical treatment is effective for patients of CTJ metastases, with a tolerable rate of complications, and prompt and aggressive decompressive surgery is recommended for CTj metastases patients with neurological impairment.

Impact of decompressive laminectomy on the functional outcome of patients with metastatic spinal cord compression and neurological impairment

A single center retrospective cohort study of neurologically impaired MSCC-patients treated with decompressive laminectomy showed beneficial effects on the functional outcome at discharge and a good neurological status prior to surgery was key predictor for a good functional outcome.

Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases

A review of the literature describing the different changes that occurred with the SINS score in the last ten years is conducted and the new SINS-derived predictive scores, biomarkers and artificial intelligence algorithms that allow a multidisciplinary approach for the management of spinal metastases are presented.

Management - spinal metastases.

A Multicenter Prospective Study of Surgery Versus Conventional Radiotherapy for the Treatment of Spinal Metastasis

Although radiotherapy was less effective for immediate pain relief, it was effective for a neurological deficit of up to FG D and surgery seemed to be more effective for spinal cord compression-induced severe dysfunctions.

Prognostic factors and surgical outcome after decompressive surgery in aged patients with metastatic spinal cord compression

Primary site, visceral metastases, and preoperative ambulatory status should be considered to help physicians select the best treatment option, especially for aged patients with MSCC.



Assessment of prognostic factors in patients with metastatic epidural spinal cord compression (MESCC) from solid tumor after surgery plus radiotherapy: a single institution experience

In the set of patients treated for vertebral metastases, PS, time to development of symptoms, and the presence of visceral metastases affected functional outcome and survival, the key element for successful treatment of MESCC is multidisciplinary care of the patient.

The role of radiotherapy for metastatic epidural spinal cord compression

Patients with a more favorable survival prognosis should receive longer- Course radiotherapy, as they may live long enough to develop a recurrence of MESCC, and patients with an expected survival of <6 months should be considered for short-course radiotherapy.

Epidural spinal cord compression from metastatic tumor: Diagnosis and treatment

It is concluded that RT without decompressive laminectomy is as effective as decompressive Laminectomy in treating epidural spinal cord compression from systemic cancer.

Metastatic Spinal Cord Compression In Patients With Colorectal Cancer

Prognostic features and outcomes for MSCC with primary colorectal cancer are similar to those for other primary sites, and there is a suggestion that rectal primary tumors may be associated with an improved outcome compared with colon primary tumors.

Metastatic spinal cord compression: radiotherapy outcome and dose fractionation.

  • P. HoskinA. GroverR. Bhana
  • Medicine
    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • 2003

Radiotherapy or surgery for spine metastases?

Better identification of patients with short survival is needed to avoid time-consuming treatment (major surgery and long-term RT), and motor impairment was the main indication for surgery.

Epidural spinal cord compression.

The era of stereotactic body radiotherapy for spinal metastases and the multidisciplinary management of complex cases.

The purpose of this review is to provide an overview of the current literature with respect to outcomes, technical details for safe delivery, patient selection criteria, common and uncommon side effects of therapy, and the increasing use of minimally invasive surgical techniques that can improve both safety and local control.