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Hematol Oncol Stem Cell Ther. 2017 Sep;10(3):143-150. doi: 10.1016/j.hemonc.2017.07.003. Epub 2017 Aug 16.

Multimodality therapy improves survival in intramedullary spinal cord metastasis of lung primary.

Author information

1
Department of Internal Medicine, Division of Hematology/BMT, Lexington, KY 40536, USA. Electronic address: hsa222@uky.edu.
2
Department of Internal Medicine, Division of Medical Oncology, Lexington, KY 40536, USA.
3
Department of Neurology, University of Kentucky, Lexington, KY 40536, USA.
4
Department of Pathology, University of Kentucky, Lexington, KY 40536, USA.
5
Biostatistics and Bioinformatics Shared Resources, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA.

Abstract

BACKGROUND:

Most metastatic spinal cord lesions are located either in the intradural, extramedullary, or in the epidural compartments. Intramedullary spinal cord metastasis (ISCM) is a rare central nervous system spread of cancer. The aim of this report was to evaluate ISCM in the published literature.

METHODS:

A literature review of PubMed from 1960 to 2016 was undertaken for the publications having demographic, clinical, histological, and outcome data.

RESULTS:

A total of 59 relevant papers were identified, showing 128 cases of intramedullary metastasis from lung cancer. The incidence of lung cancer as the primary malignancy with intramedullary metastasis was 56%. The median time from diagnosis of primary to intramedullary metastasis was 6months. Survival improved with multimodality therapy compared to monotherapy (4monthsvs. 6.3months) (hazard ratio=0.501; 95% confidence interval, 0.293-0.857).

CONCLUSION:

Lung cancer is the predominant cause of intramedullary involvement of the spinal cord. Overall prognosis is poor, although a multimodality approach was associated with improved survival.

KEYWORDS:

Intramedullary; Lung; Metastasis; Neurology; Oncology; Spinal cord

PMID:
28834695
DOI:
10.1016/j.hemonc.2017.07.003
[Indexed for MEDLINE]
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