1. Unidade de Oncologia
SPINAL CORD COMPRESSION ASSOCIATED TO METASTATIC PROSTATE CANCER Miguens, M. (1); Ferreira, F. (1); Malheiro, M. (1); Cardoso, D. (1); Fernandes, L. (1); Santos, J. (2); Nunes Marques, J. (1); Martins, A. (1) (1) Department of Medical Oncology, Hospital de São Francisco Xavier – Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal (2) Department of Urology, Hospital de Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
INTRODUCTION In Europe, prostate cancer is the leading cause of cancer among men. 90% of patients with metastatic prostate cancer (MPC) present bone metastasis, responsible for increased morbidity and mortality. Among skeletal-related events, spinal cord compression (SCC) is the most dramatic for its often irreversible consequences, being therefore desirable to establish an appropriate preventive strategy.
OBJECTIVES To assess the impact, clinical presentation, diagnostic method and therapeutic approach of MPC patients presented with SCC.
METHODSA retrospective and observational study, performed in an Oncology Department, identifying the cases of SCC in patients with MPC, over a 5-year period.
RESULTS
Of 106 patients with MPC admitted to an Oncology Department over that period, 5 were diagnosed with SCC. All them had castration-resistant tumors and presented a known vertebral metastasis.
4 patients presented sudden onset paraparesis. One patient was diagnosed before the onset of neurological compromise.
The time elapsed between bone metastasis diagnosis and the occurrence of SCC ranged 5-29 months (average 17 ± 10.1 months). The diagnosis was confirmed through magnetic resonance imaging (MRI) in all patients.
Thereafter, 3 patients received radiotherapy and 2 have undergone laminectomy and radiotherapy.
The time interval elapsed since the occurrence of SCC until death ranged 1-15 months (average 5.2 ± 5.7 months).
CASE
AGE
TREATMENT 1 53
LAM + RT 2 57 RT 3 69 4 71 5 75
CONCLUSION
SCC was diagnosed in 4.7% of the population surveyed, comparable with published data. In most cases, diagnosis is only made at a late stage, following the establishment of neurological deficits. Beyond the administration of osteoclast-targeted agents, a spine MRI must be considered to all patients with known vertebral metastasis, to allow establishing a preventive therapeutic strategy of this dramatic complication.