Spinal cord compression as the first manifestation of metastatic malignancies: A retrospective study of surgical outcomes from a single institution

• Published in: Asian journal of surgery Vol. 47; no. 8; pp. 3442 - 3447
• Main Authors: Ho, Ue-Cheung, Lai, Dar-Ming, Xiao, Fu-Ren, Yang, Shih-Hung, Chen, Chang-Mu, Tsuang, Fon-Yih
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2024; Elsevier
• Subjects: Adult; Aged; Case-Control Studies; Debulking surgery; Female; Frankel scale; Humans; Male; Metastatic spinal cord compression; Middle Aged; Palliative Care - methods; Palliative surgery; Retrospective Studies; Spinal Cord Compression - etiology; Spinal Cord Compression - mortality; Spinal Cord Compression - surgery; Spinal Neoplasms - complications; Spinal Neoplasms - mortality; Spinal Neoplasms - secondary; Spinal Neoplasms - surgery; Survival Rate; Tomita score; Treatment Outcome; Palliative surgery; Tomita score; Metastatic spinal cord compression; Debulking surgery; Frankel scale
• ISSN: 1015-9584; 0219-3108
• DOI: 10.1016/j.asjsur.2023.08.159

Given the limited studies addressing the issue about the effect of different surgical modalities for metastatic spinal cord compression (MSCC) as the first malignancy manifestation, we conducted a retrospective case-control study to evaluate the surgical outcome of MSCC as the first malignancy manifestation. A total of 128 patients who were suspected of having metastatic spinal cord compression and underwent surgery from 2008 to 2021 were enrolled in the study. All patients were categorized into either ‘debulking group’ or ‘palliative group’. The primary outcome was progression-free survival (PFS). The secondary outcomes were overall survival (OS), Frankel scale, and Karnofsky scores. All the outcomes were analyzed with a data cutoff of December 31, 2021. There was a significant difference between groups in progression-free survival (PFS) (p = 0.0094). However, there was no significant difference between groups in the overall survival (OS) (p = 0.0746). Age of onset, gender, duration of symptoms, and location of spinal metastasis, initial Frankel, initial Tomita scores, and initial Karnofsky performance scale showed no significant differences between groups. In conclusion, debulking surgery was shown to provide better neurological recoveries and could be considered first in patients with metastatic spinal cord compression as the first malignancy manifestation.