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Early diagnosis and treatment is crucial for neurological recovery after surgery for metastatic spinal cord compression in prostate cancer

Crnalic, Sead, (författare)
Umeå universitet, Ortopedi
Hildingsson, Christer, (författare)
Umeå universitet, Ortopedi
Bergh, Anders, (författare)
Umeå universitet, Patologi
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Widmark, Anders, (författare)
Umeå universitet, Onkologi
Svensson, Olle, (författare)
Umeå universitet, Ortopedi
Löfvenberg, Richard, (författare)
Umeå universitet, Ortopedi
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2013
Engelska.
Ingår i: Acta Oncologica. - London : Informa Healthcare. - 0284-186X .- 1651-226X. ; 52:4, s. 809-815
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • <p><strong>Background.</strong> Spinal cord compression is an oncological and surgical emergency. Delays in referral and diagnosis may influence functional outcome. It is therefore important to identify patients who will regain or maintain ability to walk after surgery. The aim of the present study was to examine current practice for referral and diagnosis of prostate cancer patients with spinal cord compression and to identify prognostic factors for neurological outcome after surgery.</p><p><strong>Patients and methods.</strong> The study includes<strong> </strong>68 consecutive patients with prostate cancer who underwent surgery due to neurological compromise.  Intervals from onset of neurological symptoms to referral, diagnosis, and treatment were analyzed in relation to functional outcome. The prognostic significance of preoperative clinical parameters on gait function one month after surgery was evaluated.</p><p><strong>Results.</strong> Patients who were referred from local hospitals had longer delay to surgery than those who directly presented to the cancer centre (p=0.004). The rate of diagnosis with MRI increased through the week and peaked on Friday, with few patients being diagnosed during weekends. Ability to walk before surgery, hormone-naive prostate cancer, and/or shorter time from loss of ambulation were associated with more favorable neurological outcome. In patients with hormone-refractory disease who were unable to walk before surgery regaining of ambulation was associated with: duration of paresis &lt;48 hours (p=0.005), good preoperative performance status (p=0.04), preoperative PSA serum level &lt;200 ng/ml (p=0.03), and surgery with posterior decompression and stabilization (p=0.03).</p><p><strong>Conclusion.</strong> Early diagnosis and rapid treatment of spinal cord compression in prostate cancer patients is crucial for neurological recovery. Rising of awareness for the condition among patients at risk and among physicians is mandatory as well as improvement of local and regional guidelines for treatment.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopedics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

surgical management
prognostic factors
survival
time
complications
deficit
audit
care
ortopedi
Orthopaedics
onkologi
Oncology

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Av författaren/redakt...
Crnalic, Sead
Hildingsson, Chr ...
Bergh, Anders
Widmark, Anders
Svensson, Olle
Löfvenberg, Rich ...
Om ämnet
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Ortopedi
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Cancer och onkol ...
Artiklar i publikationen
Acta Oncologica
Av lärosätet
Umeå universitet

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