Chang Ching-Ming, Chen Hung-Chieh, Yang Youngsen, Wang Ren-Ching, Hwang Wen-Li, Teng Chieh-Lin Jerry
World J Surg Oncol. 2013 Apr 19;11:90. doi: 10.1186/1477-7819-11-90.
Malignancy-associated spinal cord compression is generally treated by surgical decompression, radiotherapy or a combination of both. Since diffuse large B-cell lymphoma (DLBCL) is highly sensitive to both chemotherapy and radiotherapy, the role of surgical decompression in the treatment of DLBCL-associated spinal cord compression remains unclear. We therefore conducted a retrospective review to investigate the impact of surgical decompression on recovery from neurological deficit caused by DLBCL-associated spinal cord compression and patients' overall survival.
Between March 2001 and September 2011, 497 newly diagnosed DLBCL patients were reviewed, and 11 cases had DLBCL-associated spinal cord compression. Six cases were treated surgically and five cases nonsurgically.
The rates of complete recovery from neurological deficit were 100% (6/6) and 20% (1/5) for patients in the surgical and nonsurgical groups, respectively (P = 0.015), while the median survival for patients in the surgical and nonsurgical groups was 48.6 months and 17.8 months, respectively (P = 0.177).
We conclude that surgical decompression can improve recovery from neurological deficit in patients with DLBCL-associated spinal cord compression, possibly providing these patients a survival benefit.
恶性肿瘤相关脊髓压迫症通常采用手术减压、放疗或两者联合治疗。由于弥漫性大B细胞淋巴瘤(DLBCL)对化疗和放疗均高度敏感,手术减压在DLBCL相关脊髓压迫症治疗中的作用仍不明确。因此,我们进行了一项回顾性研究,以调查手术减压对DLBCL相关脊髓压迫症所致神经功能缺损恢复及患者总生存期的影响。
回顾2001年3月至2011年9月期间497例新诊断的DLBCL患者,其中11例发生DLBCL相关脊髓压迫症。6例行手术治疗,5例行非手术治疗。
手术组和非手术组患者神经功能缺损完全恢复率分别为100%(6/6)和20%(1/5)(P = 0.015),而手术组和非手术组患者的中位生存期分别为48.6个月和17.8个月(P = 0.177)。
我们得出结论,手术减压可改善DLBCL相关脊髓压迫症患者神经功能缺损的恢复情况,可能为这些患者带来生存益处。