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Japanese Journal of Clinical Oncology Advance Access originally published online on May 9, 2009
Japanese Journal of Clinical Oncology 2009 39(7):431-434; doi:10.1093/jjco/hyp039
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© The Author (2009). Published by Oxford University Press. All rights reserved

Vertebral Metastases with High Risk of Symptomatic Malignant Spinal Cord Compression

Yasushi Hamamoto, Masaaki Kataoka, Takatoshi Senba, Kotaro Uwatsu, Yoshifumi Sugawara, Takeshi Inoue, Shinya Sakai, Shoji Aono, Tadaaki Takahashi and Shogo Oda

Department of Radiology, Shikoku Cancer Center, Matsuyama, Ehime, Japan

For reprints and all correspondence: Yasushi Hamamoto, Department of Radiology, Shikoku Cancer Center, Kou-160, Minamiumemoto-Machi, Matsuyama 791-0280, Ehime, Japan. E-mail: yhamamot{at}shikoku-cc.go.jp

Received December 19, 2008; accepted March 26, 2009

Objective: To find vertebral metastases with high risk of symptomatic malignant spinal cord compression (MSCC), features of vertebral metastases caused motor deficits of the lower extremities were examined.

Methods: From 2004 through 2006, 78 patients with metastases of the thoracic and/or the cervical spine were treated with radiation therapy (RT). Of these, 86 irradiated lesions in 73 patients were evaluable by magnetic resonance imaging and/or computed tomography at the initiation of RT and were reviewed retrospectively in this study. Twenty-eight patients (38%) had motor deficits at the initiation of RT. Assessed factors were age, sex, primary disease (lung, breast, digestive system and other cancer), lamina involvement, main level of tumor location and vertebral-body involvement.

Results: Incidence of motor deficits at the initiation of RT was 55% for lesions with lamina involvement and 5% for lesions without lamina involvement (P < 0.0001). Incidence of motor deficits was 15% for lesions located mainly in the cervical spine and/or the upper thoracic spine (Th1–4), 54% for lesions located mainly in the middle thoracic spine (MTS) (Th5–8) and 30% for lesions located mainly in the lower thoracic spine (Th9–12) (P = 0.0095). Age, sex, primary disease and vertebral-body involvement were not statistically significant factors for incidence of motor deficits due to MSCC (P > 0.9999, P = 0.7798, P = 0.1702 and P = 0.366, respectively).

Conclusions: Vertebral metastases with lamina involvement tended to cause symptomatic MSCC. Latent development of MSCC occurred more frequently in the MTS compared with other levels of the thoracic and the cervical spine.

Key Words: neoplasm metastasis • spinal cord compression • paraplegia • risk factors


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