Profile of malignant spinal cord compression: One year study at regional cancer center

Abstract

Background and Objectives:Malignant spinal cord compression is an oncologic emergency, unless diagnosed early and treated appropriately, can lead to permanent neurological impairment and compromised quality of life of patients. We analyzed the epidemiology and the effect of common interventions on the outcome in these patients.Patients and Methods:We conducted a prospective study of 77 patients in the year 2014 and recorded relevant patient and disease characteristics. All patients received corticosteroids. Eight patients were operated upon, and radiotherapy was delivered in 62 patients.Results:Most of the patients were in the age group of 41–60 years and there was no gender preponderance in patients. Female breast cancer was the most common incident (15.5%) malignancy followed by multiple myeloma, lung, and prostatic carcinoma. Lower dorsal spine was the most common site of compression (35%) followed by lumbar (31%) and mid-dorsal (26%) spine. 70 (91%) patients had cord compression subsequent to bone metastasis while as other patients had leptomeningeal metastasis. In 31 (40%) patients, spinal cord compression was the presenting symptom. Overall, only 26 patients had motor improvement after treatment.Conclusion:Grade of power before treatment was predictive of response to treatment and overall outcome of motor or sensory functions. Neurodeficit of more than 10 days duration was associated with poor outcome in neurological function.

Malignant Spinal Cord Compression, Early Clinical Outcome.

“…Only 42% of patients have paraspinal mass compressing the spinal cord, 25% of the studied populations have visceral mets at time of diagnosis. In the study done by Malik Tariq Rasool, Kaneez Fatima et al ,the type of vertebrae that had been affected in studied population was dorsal (72%), lumber (27.5%),cervical( 8%) (Rasool, Fatima et al 2016).…”

“…Malik Tariq Rasool, Kaneez Fatima et al found in their study that15.5 % of MSCC cases were caused by breast cancer, 12.9 % caused by myeloma, 11.6% caused by lung cancer, 10.3% caused by prostate cancer, 49% caused by others (Rasool, Fatima et al 2016). While Bach, Larsen et al stated that 19 % of MSCC cases was caused by prostate cancer, 18% caused by lung cancer 14%caused by breast cancer, 10% caused by renal carcinoma, 4% caused by myeloma and 36% caused by others (Bach, Larsen et al 1990).…”

“…Malik Tariq Rasool, Kaneez Fatima et al stated that 40% of cases presented with MSCC at time of diagnosis, 26% presented with MSCC within less than 12 months from tumor diagnosis, 16.8% presented within 13-24 months from time of diagnosis, and also 16.8% presented within more than 2years from time of diagnosis (Rasool, Fatima et al 2016).Another study done by Bach, Larsen et al stated that 80% of the patients had their malignancy diagnosis at the time of SCC, although the mean period from the primary malignant diagnosis to the SCC varied considerably according to the type of the primary turnout, lung: 0.5 years, prostate: 1.7 years, kidney: 2.2 years and breast: 4.6 years (Bach, Larsen et al 1990). In the current study most of the patients (70.8%) of studied population were managed by radiotherapy, 12.5% managed by surgery and 16.7% managed by both.…”

“…This is similar to Malik Tariq Rasool, Kaneez Fatima et al, where radiotherapy was delivered in 62 (81%) patients. No surgery or radiation therapy treatment was delivered in 12 patients due to poor prognostic features and low performance score (Rasool, Fatima et al 2016). Also Bach, Larsen et al stated that of the 365 treated patients, most of them (43%) received treatment in the form of radiotherapy, 31% in form of laminectomy, and 26% in form of laminectomy followed by radiotherapy (Bach, Larsen et al 1990.…”

“…Thus, grade of power before treatment was predictive of response to treatment and overall outcome of motor or sensory functions. Delay of treatment by more than 10 days was associated with poor outcome in neurological function (Rasool, Fatima et al 2016).…”