Diagnosis and treatment of epidural metastases

Cancer. 2017 Apr 1;123(7):1106-1114. doi: 10.1002/cncr.30521. Epub 2016 Dec 27.

Abstract

Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Moreover, current treatment paradigms are reviewed. The timely initiation of radiation as well as surgery in select cases is critical for preserving neurological function and achieving local tumor control and pain control. Future studies investigating surgical and radiation treatment for metastatic epidural cord compression are urgently needed. Cancer 2017;123:1106-1114. © 2016 American Cancer Society.

Keywords: cancer; cauda equina; epidural; metastases; neurological deficit; paralysis; radiation; spinal cord.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Combined Modality Therapy / methods
  • Epidural Neoplasms / diagnosis*
  • Epidural Neoplasms / epidemiology
  • Epidural Neoplasms / secondary*
  • Epidural Neoplasms / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasms / pathology*
  • Prognosis
  • Treatment Outcome