Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center

被引：4
作者：
Gao, Xin [1 ]
Zhang, Kun [1 ]
Cao, Shuang [1 ,2 ]
Hou, Shuming [1 ]
Wang, Tao [1 ]
Guo, Wen [1 ,3 ]
Wu, Zheyu [1 ,4 ]
Jia, Qi [1 ]
Liu, Tielong [1 ]
Xiao, Jianru [1 ]
机构：
[1] Second Mil Med Univ, Changzheng Hosp, Orthopaed Oncol Ctr, Dept Orthoped, Shanghai, Peoples R China
[2] Anhui Med Univ, Dept Orthoped, Affiliated Hosp 3, Hefei, Anhui, Peoples R China
[3] Taizhou Peoples Hosp, Dept Orthoped, Taizhou, Jiangsu, Peoples R China
[4] Wuhan Univ, Dept Orthoped, Zhongnan Hosp, Wuhan, Hubei, Peoples R China
来源：
CANCER MANAGEMENT AND RESEARCH | 2020年 / 12卷
关键词：
small cell lung cancer; spinal cord compression; surgery; quality of life; prognostic factor; immunotherapy; QUALITY-OF-LIFE; PROGNOSTIC-FACTORS; SURGERY; MULTICENTER; OUTCOMES; PATIENT; TIME;
D O I：
10.2147/CMAR.S250422
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose: Metastatic spinal cord compression (SCC) secondary to small cell lung cancer (SCLC) is a disastrous oncological emergency, but it is poorly understood due to the small numbers of patients and their short survival times. Whether patients suffered from SCC caused by metastatic SCLC benefit from spinal surgery remains unknown. The aim of this study was to evaluate the role of surgical treatment and prognostic factors in patients with SCC caused by metastatic SCLC. Methods: From 2009 to 2019, 30 consecutive patients surgically treated for metastatic SCC from SCLC were enrolled in this retrospective analysis. Kaplan-Meier method and Cox regression analysis were used to estimate overall survival (OS) and identify prognostic factors. Quality of life (QoL) was assessed by the three-level EuroQol-five-Dimensions (EQ-5D-3L) instrument and compared using Student's t test. Results: The median OS time was 9 months in our series. Relief of pain, preservation of neurological function, and improvement of performance status were achieved after surgical intervention. The mean EQ-5D-3L utility score showed a significant improvement after surgery (0.3394 preoperatively vs 0.5884 postoperatively). According to Cox regression analysis, postoperative ECOG-PS and immunotherapy were identified to be independent prognostic factors for patients with SCC caused by metastatic SCLC. Conclusion: Despite the short life expectancy, prompt surgical decompression is extremely necessary for patients with SCC caused by SCLC, for surgery played a critical role in improving patients' QoL. Better performance status after surgery and receiving immunotherapy were associated with a longer OS.
引用
收藏
页码：3571 / 3578
页数：8
相关论文
共 34 条
[1]   Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial [J].
Antonia, Scott J. ;
Lopez-Martin, Jose A. ;
Bendell, Johanna ;
Ott, Patrick A. ;
Taylor, Matthew ;
Eder, Joseph Paul ;
Jaeger, Dirk ;
Pietanza, M. Catherine ;
Le, Dung T. ;
de Braud, Filippo ;
Morse, Michael A. ;
Ascierto, Paolo A. ;
Horn, Leora ;
Amin, Asim ;
Pillai, Rathi N. ;
Evans, Jeffry ;
Chau, Ian ;
Bono, Petri ;
Atmaca, Akin ;
Sharma, Padmanee ;
Harbison, Christopher T. ;
Lin, Chen-Sheng ;
Christensen, Olaf ;
Calvo, Emiliano .
LANCET ONCOLOGY, 2016, 17 (07) :883-895
[2]   Spinal extradural metastasis: Review of current treatment options [J].
Bartels, Ronald H. M. A. ;
van der Linden, Yvette M. ;
van der Graaf, Winette T. A. .
CA-A CANCER JOURNAL FOR CLINICIANS, 2008, 58 (04) :245-259
[3]   Integrating Evidence-Based Medicine for Treatment of Spinal Metastases Into a Decision Framework: Neurologic, Oncologic, Mechanicals Stability, and Systemic Disease [J].
Barzilai, Ori ;
Laufer, Ilya ;
Yamada, Yoshiya ;
Higginson, Daniel S. ;
Schmitt, Adam M. ;
Lis, Eric ;
Bilsky, Mark H. .
JOURNAL OF CLINICAL ONCOLOGY, 2017, 35 (21) :2419-+
[4]   Reliability analysis of the epidural spinal cord compression scale Clinical article [J].
Bilsky, Mark H. ;
Laufer, Ilya ;
Fourney, Daryl R. ;
Groff, Michael ;
Schmidt, Meic H. ;
Varga, Peter Paul ;
Vrionis, Frank D. ;
Yamada, Yoshiya ;
Gerszten, Peter C. ;
Kuklo, Timothy R. .
JOURNAL OF NEUROSURGERY-SPINE, 2010, 13 (03) :324-328
[5]  
Bouras T, 2018, WORLD NEUROSURG, V111, pE573, DOI 10.1016/j.wneu.2017.12.107
[6]   Survival and Clinical Outcomes in Surgically Treated Patients With Metastatic Epidural Spinal Cord Compression: Results of the Prospective Multicenter AOSpine Study [J].
Fehlings, Michael G. ;
Nater, Anick ;
Tetreault, Lindsay ;
Kopjar, Branko ;
Arnold, Paul ;
Dekutoski, Mark ;
Finkelstein, Joel ;
Fisher, Charles ;
France, John ;
Gokaslan, Ziya ;
Massicotte, Eric ;
Rhines, Laurence ;
Rose, Peter ;
Sahgal, Arjun ;
Schuster, James ;
Vaccaro, Alexander .
JOURNAL OF CLINICAL ONCOLOGY, 2016, 34 (03) :268-U136
[7]   A Novel Classification System for Spinal Instability in Neoplastic Disease An Evidence-Based Approach and Expert Consensus From the Spine Oncology Study Group [J].
Fisher, Charles G. ;
DiPaola, Christian P. ;
Ryken, Timothy C. ;
Bilsky, Mark H. ;
Shaffrey, Christopher I. ;
Berven, Sigurd H. ;
Harrop, James S. ;
Fehlings, Michael G. ;
Boriani, Stefano ;
Chou, Dean ;
Schmidt, Meic H. ;
Polly, David W. ;
Biagini, Roberto ;
Burch, Shane ;
Dekutoski, Mark B. ;
Ganju, Aruna ;
Gerszten, Peter C. ;
Gokaslan, Ziya L. ;
Groff, Michael W. ;
Liebsch, Norbert J. ;
Mendel, Ehud ;
Okuno, Scott H. ;
Patel, Shreyaskumar ;
Rhines, Laurence D. ;
Rose, Peter S. ;
Sciubba, Daniel M. ;
Sundaresan, Narayan ;
Tomita, Katsuro ;
Varga, Peter P. ;
Vialle, Luiz R. ;
Vrionis, Frank D. ;
Yamada, Yoshiya ;
Fourney, Daryl R. .
SPINE, 2010, 35 (22) :E1221-E1229
[8]   Phase II Study of Maintenance Pembrolizumab in Patients with Extensive-Stage Small Cell Lung Cancer (SCLC) [J].
Gadgeel, Shirish M. ;
Pennell, Nathan A. ;
Fidler, Mary Jo ;
Halmos, Balazs ;
Bonomi, Philip ;
Stevenson, James ;
Schneider, Bryan ;
Sukari, Ammar ;
Ventimiglia, Jaclyn ;
Chen, Wei ;
Galasso, Cathy ;
Wozniak, Antoinette ;
Boerner, Julie ;
Kalemkerian, Gregory P. .
JOURNAL OF THORACIC ONCOLOGY, 2018, 13 (09) :1393-1399
[9]  
Gazdar AF, 2017, NAT REV CANCER, V17, P725, DOI [10.1038/nrc.2017.87, 10.1038/nrc.2017.106]
[10]   SPINAL-CORD COMPRESSION IN SMALL CELL LUNG-CANCER - A RETROSPECTIVE STUDY OF 610 PATIENTS [J].
GOLDMAN, JM ;
ASH, CM ;
SOUHAMI, RL ;
GEDDES, DM ;
HARPER, PG ;
SPIRO, SG ;
TOBIAS, JS .
BRITISH JOURNAL OF CANCER, 1989, 59 (04) :591-593
1234