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Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression.

Publication ,  Journal Article
Barzilai, O; Versteeg, AL; Goodwin, CR; Sahgal, A; Rhines, LD; Sciubba, DM; Schuster, JM; Weber, MH; Lazary, A; Fehlings, MG; Clarke, MJ ...
Published in: Cancer
December 1, 2019

BACKGROUND: A critical knowledge gap exists regarding the impact of neurologic deficits on surgical outcomes and health-related quality of life (HRQOL) for patients surgically treated for metastatic epidural spinal cord compression (MESCC). METHODS: This prospective, multicenter and international study analyzed the impact of the neurologic status on functional status, HRQOL, and postoperative survival. The collected data included the patient demographics, overall survival, American Spinal Injury Association (ASIA) impairment scale, Spinal Instability Neoplastic Score, treatment details and complications and HRQOL measures, including version 2 of the 36-Item Short Form Health Survey (SF-36v2) and version 2.0 of the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0). RESULTS: A total of 239 patients surgically treated for spinal metastases were included. Six weeks after treatment, 99 of the 108 patients with a preoperative ASIA grade of E remained stable, 8 deteriorated to ASIA D, and 1 deteriorated to ASIA A. Of 55 patients with ASIA D, 27 improved to ASIA E, 27 remained stable and 1 deteriorated to ASIA C. Of 11 patients with ASIA A to C, 2 improved to ASIA E, 4 improved to ASIA D, and 5 remained stable. At the 6- and 12-week follow-up, better ASIA scores were associated with better scores on multiple SF-36v2 and SOSGOQ items. Postoperatively, patients with ASIA grades of A to D were more likely to have urinary tract infections and wound complications. Patients with a baseline ASIA grade of E or D survived significantly longer. CONCLUSIONS: Patients with neurologic deficits due to MESCC have worse HRQOL and decreased overall survival. Nevertheless, surgery can result in stabilization or improvement of neurologic function which may translate into better HRQOL. Postoperative care and follow-up are challenging for patients with neurologic deficits because they experience more complications.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

December 1, 2019

Volume

125

Issue

23

Start / End Page

4224 / 4231

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Spinal Neoplasms
  • Spinal Cord Compression
  • Quality of Life
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Barzilai, O., Versteeg, A. L., Goodwin, C. R., Sahgal, A., Rhines, L. D., Sciubba, D. M., … AOSpine Knowledge Forum Tumor, . (2019). Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression. Cancer, 125(23), 4224–4231. https://doi.org/10.1002/cncr.32420
Barzilai, Ori, Anne L. Versteeg, C Rory Goodwin, Arjun Sahgal, Laurence D. Rhines, Daniel M. Sciubba, James M. Schuster, et al. “Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression.Cancer 125, no. 23 (December 1, 2019): 4224–31. https://doi.org/10.1002/cncr.32420.
Barzilai O, Versteeg AL, Goodwin CR, Sahgal A, Rhines LD, Sciubba DM, et al. Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression. Cancer. 2019 Dec 1;125(23):4224–31.
Barzilai, Ori, et al. “Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression.Cancer, vol. 125, no. 23, Dec. 2019, pp. 4224–31. Pubmed, doi:10.1002/cncr.32420.
Barzilai O, Versteeg AL, Goodwin CR, Sahgal A, Rhines LD, Sciubba DM, Schuster JM, Weber MH, Lazary A, Fehlings MG, Clarke MJ, Arnold PM, Boriani S, Bettegowda C, Gokaslan ZL, Fisher CG, Laufer I, AOSpine Knowledge Forum Tumor. Association of neurologic deficits with surgical outcomes and health-related quality of life after treatment for metastatic epidural spinal cord compression. Cancer. 2019 Dec 1;125(23):4224–4231.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

December 1, 2019

Volume

125

Issue

23

Start / End Page

4224 / 4231

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Spinal Neoplasms
  • Spinal Cord Compression
  • Quality of Life
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Middle Aged
  • Male