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The CancerWeb Report, What's New In Cancer
Spinal Disease: September 1995
Last modified on:
Tuesday, April 20, 1999 12:03:12
Copyright © 1994-2008, Information Ventures, Inc.
Metastases to the Spine - About one in three patients with solid tumors develops metastases
to the spine, a figure which appears to be increasing. In about one sixth of these patients, the metastases compress the spinal
cord, eventually leading to neurological deterioration, seen as severe unrelenting pain, partial paralysis, and difficulty or
inability to walk. Radiation has been widely used to palliate this problem, but surgery is frequently required later, and the
radiation often causes complications for wound healing in exposed areas. Dr. Sundarasan from Mount Sinai Hospital in New York,
described in the September, 1995 issue of the Journal of Clinical Oncology the results of sugical intervention, guided by MRI
and/or CT. Treatment included complete tumor resection and stabilization, termed instrumentation, of the spine. Of 110
patients, 90 (82%) patients improved in terms of pain reduction and ability to walk. This compared with less than 50% by
surgery-laminectomy or radiotherapy alone. Median survival was 16 months, with two-year survival averaging 46% (range 17% for
lung to 84% for chordoma). The 48% incidence of postoperative complications was largely associated with age over 65, prexisting
partial paralysis (which presumably had caused irreversible nerve damage), and prior treatment.
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