Metastatic spinal cord compression as the fi rst sign of malignancy Outcome after surgery in 69 patients

Metastatic spinal cord compression (MSCC) can be the first sign of an unknown cancer, presenting challenges in diagnosis and treatment. This study evaluates the outcomes of surgery for MSCC when it is the initial manifestation of malignancy (IMM). The study reviewed records of 69 patients who underwent surgery for MSCC as the IMM to determine neurological outcome, complications, survival, and how the primary tumor was diagnosed. The primary tumor was identified in 59 patients, while 10 patients were classified as having cancer of unknown primary tumor (CUP). Overall survival was 20 months, with prostate cancer and myeloma patients showing the longest survival times. A significant number of non-ambulatory patients regained walking ability postoperatively, and most ambulatory patients retained their walking ability. The study concludes that postoperative survival with MSCC as the IMM depends on the type of primary tumor. Surgery can help maintain or improve the ability to walk. The study highlights the importance of identifying the primary tumor to guide further treatment and improve survival outcomes.

• 1
  Postoperative survival depends on the type of primary tumor, with prostate cancer and myeloma showing the longest survival.
• 2
  Surgery maintains and improves ambulatory function in patients with MSCC as the IMM; 20 of 39 patients regained walking ability.
• 3
  The primary tumor was identified in 85% of patients, highlighting the importance of diagnostic workup.