Kuban D A, el-Mahdi A M, Sigfred S V, Schellhammer P F, Babb T J
Urology. 1986 Nov;28(5):364-9. doi: 10.1016/0090-4295(86)90062-2.
Of 611 patients with biopsy-proved adenocarcinoma of the prostate, spinal cord compression developed in 41 (6.7%) at a median interval of twenty-four months after primary diagnosis. Spinal cord involvement most often occurred in the thoracic area, with 95 per cent of patients showing radiographic evidence of osseous vertebral metastasis at the level of cord compression. All lesions but one were located extradurally, and patients with Stage D2 disease, by virtue of bony metastases, were therefore at greatest risk for development of neurologically compressive disease. There was also a significant increase in the incidence of spinal cord involvement among the more poorly differentiated tumors, although tumor histology did not appear to influence the median interval between vertebral metastasis and cord compromise. Survival following spinal cord involvement was relatively poor and unrelated to tumor differentiation. Forty-six per cent of patients survived less than six months and 20 per cent less than two months. The two most noteworthy survivors are alive at thirty and ninety-seven months, the latter after combined treatment for an intradural lesion.
在611例经活检证实为前列腺腺癌的患者中，41例（6.7%）发生了脊髓压迫，自初次诊断后的中位间隔时间为24个月。脊髓受累最常发生在胸部，95%的患者在脊髓受压水平显示有椎体骨转移的影像学证据。除1例外，所有病变均位于硬膜外，因此，伴有骨转移的D2期疾病患者发生神经受压性疾病的风险最大。在分化较差的肿瘤中，脊髓受累的发生率也显著增加，尽管肿瘤组织学似乎并未影响椎体转移与脊髓损害之间的中位间隔时间。脊髓受累后的生存率相对较低，且与肿瘤分化无关。46%的患者存活时间不到6个月，20%的患者存活时间不到2个月。两位最值得注意的幸存者分别在30个月和97个月时仍存活，后者是在对硬膜内病变进行联合治疗后存活的。
