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

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Abstract

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.

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Authors and Affiliations

  1. Neurosurgery Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Oscar Godino & Luis Lopez-Obarrio

  2. Radiation Oncology Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain

    Ignacio Visus, Hector Pérez, Leyre Asiaín & Arturo Navarro-Martin

  3. Orthopedic Surgery Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Iago Garreta & Lluis González-Cañas

  4. Neuroradiology Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Juan José Sanchez

  5. Oncology Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain

    Mar Marin

  6. Internal Medicine Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Abelardo Montero

Authors
  1. Oscar Godino
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  2. Ignacio Visus
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  4. Luis Lopez-Obarrio
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Corresponding authors

Correspondence to Oscar Godino or Arturo Navarro-Martin.

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Godino, O., Visus, I., Garreta, I. et al. Spinal cord compression of neoplastic origin: surgical experience using a common clinical language. Clin Transl Oncol 24, 1932–1939 (2022). https://doi.org/10.1007/s12094-022-02843-6

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  • DOI: https://doi.org/10.1007/s12094-022-02843-6

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