Abstract:
INTRODUCTION:Intramedullary spinal cord metastases (ISCMs) are rare lesions affecting the spinal cord in patients with disseminated malignancy. Today, due to increased survival, these lesions are more frequently diagnosed. Literature on survival and neurologic outcomes is sparse. Herein, we describe a single institutional case series on ISCMs reported to date in the English literature. METHODS:We retrospectively analyzed the medical records of patients diagnosed with intramedullary metastatic lesions at our institution between 1997 and 2016. We analyzed different approaches to management and factors influencing survival and neurologic outcomes. RESULTS:A total of 70 patients (86 lesions) were analyzed. Most lesions were found in thoracic spinal cord (50%) followed by cervical (34%) and conus medullaris (14%). Mean age at diagnosis was 55.6 ± 10.6 years with 60% (n = 42) being females. Median survival was 104.5 days (range 1-888 days). Twenty-three patients (33%) received conservative management, 39 (56%) received palliative radiotherapy, whereas 8 (11%) underwent surgery with one patient receiving only a biopsy. Age, sex, presence of concomitant brain and other systemic metastasis didn't influence survival. Patients with solitary metastases had longer survival compared to multiple lesions (3.6 vs. 2.2 months, p = 0.01). In patients with solitary lesions without brain metastasis, surgical resection was associated with significantly longer survival (6 months vs. 3 months, p = 0.02). CONCLUSION:The overall survival in patients with intramedullary metastasis remains poor. Surgical management may contribute to improved survival and neurologic outcomes in selected patients. Intramedullary metastasis may have a greater role on overall survival compared to systemic metastatic burden.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Goyal A,Yolcu Y,Kerezoudis P,Alvi MA,Krauss WE,Bydon Mdoi
10.1007/s11060-019-03105-2subject
Has Abstractpub_date
2019-04-01 00:00:00pages
347-354issue
2eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-019-03105-2journal_volume
142pub_type
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pub_type: 临床试验,杂志文章
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