Annals of Surgical Oncology

, Volume 19, Issue 1, pp 294–300

Early Surgical Experience with Minimally Invasive Percutaneous Approach for Patients with Metastatic Epidural Spinal Cord Compression (MESCC) to Poor Prognoses

  • Flavio Tancioni
  • Pierina Navarria
  • Federico Pessina
  • Simona Marcheselli
  • Elisa Rognone
  • Pietro Mancosu
  • Armando Santoro
  • Riccardo Rodriguez Y. Baena
Neuro-Oncology

DOI: 10.1245/s10434-011-1894-x

Cite this article as:
Tancioni, F., Navarria, P., Pessina, F. et al. Ann Surg Oncol (2012) 19: 294. doi:10.1245/s10434-011-1894-x

Abstract

Purpose

This study was designed to assess the impact of minimally invasive surgery (MIS) for the treatment of patients with metastatic epidural spinal cord compression (MESCC) and vertebral body fracture, in terms of feasibility, clinical improvement, and morbidity.

Methods

Twenty-five consecutive patients with diagnosis of MESCC from solid primary tumors were treated between January 2008 and June 2010 at our institution. All patients, after multidisciplinary assessment, were considered with poor prognosis because of their disease’s extension and/or other clinical conditions. Mini-invasive percutaneous surgery was performed in all patients followed by radiotherapy within 2 weeks postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel Scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan.

Results

Clinical remission of pain was obtained in the vast majority of patients (96%). Improvement of neurological deficit was observed in 22 patients (88%). No major morbidity or perioperative mortality occurred. The average hospital stay was 6 days. Local recurrence occurred in two patients (8%). Median survival was 10 (range, 6–24) months. Overall survival at 1 year was 43%.

Conclusions

For patients with MESCC and body fracture, with limited life expectancy, minimally invasive spinal surgery followed by radiotherapy, is feasible and provides clinical benefit in most of patients, with low morbidity. We believe that a minimally invasive approach can be an alternative surgical method compared with more aggressive or demanding procedures, which in selected patients with metastatic spinal cord compression with poor prognosis could represent overtreatment.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Flavio Tancioni
    • 1
    • 6
  • Pierina Navarria
    • 2
  • Federico Pessina
    • 1
  • Simona Marcheselli
    • 3
  • Elisa Rognone
    • 4
  • Pietro Mancosu
    • 2
  • Armando Santoro
    • 5
  • Riccardo Rodriguez Y. Baena
    • 1
  1. 1.Department of NeurosurgeryIstituto Clinico Humanitas Cancer CenterMilanItaly
  2. 2.Department of Radiotherapy and RadiosurgeryIRCCS Istituto Clinico HumanitasRozzanoItaly
  3. 3.NeurologyIstituto Clinico Humanitas Cancer CenterMilanItaly
  4. 4.NeuroradiologyIstituto Clinico Humanitas Cancer CenterMilanItaly
  5. 5.Oncology and HematologyIstituto Clinico Humanitas Cancer CenterMilanItaly
  6. 6.Department of NeurosurgeryIstituto Clinico Città StudiMilanItaly