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

Xin Gao,1,* Kun Zhang,1,* Shuang Cao,1,2,* Shuming Hou,1,* Tao Wang,1 Wen Guo,1,3 Zheyu Wu,1,4 Qi Jia,1 Tielong Liu,1 Jianru Xiao1 1Orthopaedic Oncology Center, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 2Depart...

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Main Authors: Gao X, Zhang K, Cao S, Hou S, Wang T, Guo W, Wu Z, Jia Q, Liu T, Xiao J
Format: Article
Language:English
Published: Dove Medical Press 2020-05-01
Series:Cancer Management and Research
Subjects:
Online Access:https://www.dovepress.com/surgical-treatment-of-spinal-cord-compression-caused-by-metastatic-sma-peer-reviewed-article-CMAR
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author Gao X
Zhang K
Cao S
Hou S
Wang T
Guo W
Wu Z
Jia Q
Liu T
Xiao J
author_facet Gao X
Zhang K
Cao S
Hou S
Wang T
Guo W
Wu Z
Jia Q
Liu T
Xiao J
author_sort Gao X
collection DOAJ
description Xin Gao,1,* Kun Zhang,1,* Shuang Cao,1,2,* Shuming Hou,1,* Tao Wang,1 Wen Guo,1,3 Zheyu Wu,1,4 Qi Jia,1 Tielong Liu,1 Jianru Xiao1 1Orthopaedic Oncology Center, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 2Department of Orthopedics, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 3Department of Orthopedics, Taizhou People’s Hospital, Taizhou, Jiangsu Province, People’s Republic of China; 4Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tielong Liu; Jianru XiaoOrthopaedic Oncology Center, Department of Orthopaedics, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, People’s Republic of ChinaTel +0086-021-81886843Fax +0086-021-63520020Email liutielongvip@163.com; xiaojianruvip@163.comPurpose: 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.Keywords: small cell lung cancer, spinal cord compression, surgery, quality of life, prognostic factor, immunotherapy
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spelling doaj.art-fdf61f30f5894f2a88ab26d548c62c192022-12-22T00:42:49ZengDove Medical PressCancer Management and Research1179-13222020-05-01Volume 123571357853864Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single CenterGao XZhang KCao SHou SWang TGuo WWu ZJia QLiu TXiao JXin Gao,1,* Kun Zhang,1,* Shuang Cao,1,2,* Shuming Hou,1,* Tao Wang,1 Wen Guo,1,3 Zheyu Wu,1,4 Qi Jia,1 Tielong Liu,1 Jianru Xiao1 1Orthopaedic Oncology Center, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 2Department of Orthopedics, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 3Department of Orthopedics, Taizhou People’s Hospital, Taizhou, Jiangsu Province, People’s Republic of China; 4Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tielong Liu; Jianru XiaoOrthopaedic Oncology Center, Department of Orthopaedics, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, People’s Republic of ChinaTel +0086-021-81886843Fax +0086-021-63520020Email liutielongvip@163.com; xiaojianruvip@163.comPurpose: 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.Keywords: small cell lung cancer, spinal cord compression, surgery, quality of life, prognostic factor, immunotherapyhttps://www.dovepress.com/surgical-treatment-of-spinal-cord-compression-caused-by-metastatic-sma-peer-reviewed-article-CMARsmall cell lung cancerspinal cord compressionsurgeryquality of lifeprognostic factorimmunotherapy
spellingShingle Gao X
Zhang K
Cao S
Hou S
Wang T
Guo W
Wu Z
Jia Q
Liu T
Xiao J
Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
Cancer Management and Research
small cell lung cancer
spinal cord compression
surgery
quality of life
prognostic factor
immunotherapy
title Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
title_full Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
title_fullStr Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
title_full_unstemmed Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
title_short Surgical Treatment of Spinal Cord Compression Caused by Metastatic Small Cell Lung Cancer: Ten Years of Experience in a Single Center
title_sort surgical treatment of spinal cord compression caused by metastatic small cell lung cancer ten years of experience in a single center
topic small cell lung cancer
spinal cord compression
surgery
quality of life
prognostic factor
immunotherapy
url https://www.dovepress.com/surgical-treatment-of-spinal-cord-compression-caused-by-metastatic-sma-peer-reviewed-article-CMAR
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