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      Síndrome de compresión medular como manifestación de un carcinoma de células no pequeñas Translated title: Spinal cord compression syndrome as a manifestation of a non-small cell carcinoma

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          Abstract

          Resumen Una complicación importante que ocurre entre 5 y 10% de los pacientes con cáncer es el síndrome de compresión medular que representa una urgencia oncológica. Existe relación entre el cáncer pulmonar y el síndrome de compresión medular, porque puede ocurrir infiltración del cáncer a la columna vertebral. Sin embargo, no es frecuente que ocurra como manifestación inicial. Se comunica el caso de un paciente de 40 años de edad diagnosticado con adenocarcinoma pulmonar que tuvo como manifestación inicial una paraplejía.

          Translated abstract

          Abstract An important complication that occurs between 5 and 10% of patients with cancer is spinal cord compression syndrome that represents an oncological emergency. There is a relationship between lung cancer and spinal cord compression syndrome, because cancer can infiltrate the spine. However, it is not common to occur as an initial manifestation. We report the case of a 40-year-old patient diagnosed with pulmonary adenocarcinoma who had paraplegia as an initial manifestation.

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          Matched pair analysis comparing surgery followed by radiotherapy and radiotherapy alone for metastatic spinal cord compression.

          The appropriate treatment for MSCC is controversial. A small randomized trial showed that decompressive surgery followed by radiotherapy was superior to radiotherapy alone. That study was limited to highly selected patients. Additional studies comparing surgery plus radiotherapy to radiotherapy could better clarify the role of surgery. Data from 108 patients receiving surgery plus radiotherapy were matched to 216 patients (1:2) receiving radiotherapy alone. Groups were matched for 11 potential prognostic factors and compared for post-treatment motor function, ambulatory status, regaining ambulatory status, local control, and survival. Subgroup analyses were performed for patients receiving adequate surgery (direct decompressive surgery plus stabilization of involved vertebrae), patients receiving laminectomy, patients with solid tumors, patients with solid tumors receiving adequate surgery, and patients with solid tumors receiving laminectomy. Improvement of motor function occurred in 27% of patients after surgery plus radiotherapy and 26% after radiotherapy alone (P = .92). Post-treatment ambulatory rates were 69% after surgery plus radiotherapy and 68% after radiotherapy alone (P = .99). Of the nonambulatory patients, 30% and 26%, respectively, (P = .86) regained ambulatory status after treatment. One-year local control rates were 90% after surgery plus radiotherapy and 91% after radiotherapy alone (P = .48). One-year overall survival rates were 47% and 40%, respectively (P = .50). The subgroup analyses did not show significant differences between both groups. Surgery-related complications occurred in 11% of patients. In this study, the outcomes of the end points evaluated after radiotherapy alone appeared similar to those of surgery plus radiotherapy. A new randomized trial comparing both treatments is justified.
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            Clinical outcome of metastatic spinal cord compression treated with surgical excision ± radiation versus radiation therapy alone: a systematic review of literature.

            Systematic literature review from 1970 to 2007.
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              Incidence, associated factors, and survival in metastatic spinal cord compression secondary to lung cancer.

              Bone metastasis (BM) occurs frequently in patients with lung cancer (LC). The most affected are the bones of the spine, increasing the risk of developing metastatic spinal cord compression (MSCC). Although MSCC is one of the most disabling complications, few studies have reported relevant results related to its frequency and prognosis among patients with LC.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mim
                Medicina interna de México
                Med. interna Méx.
                Edición y Farmacia S.A. de C.V. (Ciudad de México, Ciudad de México, Mexico )
                0186-4866
                February 2019
                : 35
                : 1
                : 154-158
                Affiliations
                [3] Lima orgnameHospital Nacional Dos de Mayo orgdiv1Departamento de Medicina Perú
                [1] Lima orgnameUniversidad Peruana de Ciencias Aplicadas orgdiv1Escuela de Medicina Peru
                [4] Lima orgnameUniversidad Peruana de Ciencias Aplicadas orgdiv1Sociedad Científica de Estudiantes de Medicina Peru
                [2] Lima orgnameHospital Nacional Hipólito Unanue orgdiv1Departamento de Medicina Perú
                Article
                S0186-48662019000100154 S0186-4866(19)03500100154
                10.24245/mim.v35i1.1987
                283403c4-9fb4-47a5-bb3b-c736a4509ed5

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 07 February 2018
                : 09 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 5
                Product

                SciELO Mexico

                Categories
                Casos clínicos

                Pulmonary adenocarcinoma,adenocarcinoma pulmonar,Síndrome de compresión medular,Spinal cord compression syndrome

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