Intraspinal neuroblastoma: Treatment options and neurological outcome of spinal cord compression

Fawzy,Mohamed; El‑Beltagy,Mohamed; El Shafei,Maged; Zaghloul,Mohamed Saad; Al Kinaai,Naglaa; Refaat,Amal; Azmy,Sarah

doi:10.3892/ol.2014.2795

February-2015 Volume 9 Issue 2

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February-2015 Volume 9 Issue 2

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Article

Intraspinal neuroblastoma: Treatment options and neurological outcome of spinal cord compression

Authors:
- Mohamed Fawzy
- Mohamed El‑Beltagy
- Maged El Shafei
- Mohamed Saad Zaghloul
- Naglaa Al Kinaai
- Amal Refaat
- Sarah Azmy
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Affiliations: Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Neurosurgery, Kasr El‑Aini Faculty of Medicine, Cairo University, Cairo, Egypt, Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Radiotherapy, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Radiology, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Research, Children's Cancer Hospital of Egypt (CCHE/57357), Cairo, Egypt
Pages: 907-911
|
Published online on: December 12, 2014

https://doi.org/10.3892/ol.2014.2795
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Abstract

Malignant spinal cord compression (MSCC) is a common complication of cancer. Paraspinal neuroblastoma (NB) in the thoracic, abdominal and pelvic regions may extend into the neural foramina causing compression of nerve roots and even the spinal cord. The prompt initiation of specific treatment can improve the neurological outcome. The aim of the present study was to review the clinical features, the management received and the factors that may affect the outcome of patients with MSCC caused by paraspinal NB. During a period between July 2007 and December 2012, a total of 576 NB patients were treated at the Children's Cancer Hospital (Cairo, Egypt). Intraspinal disease extension was present in 51 patients (9%). The children with intraspinal disease extension were reviewed for disease pattern, neurological manifestations and treatment outcome. Children with intraspinal disease extension had an equal male to female ratio (1:1), and approximately two‑thirds of patients (34/51) had a clinically manifested cord compression. The duration of neurological manifestations was >4 weeks in 58.8% (20/34) of symptomatic patients and ≤4 weeks in 41.2% (14/34). Subsequent to starting treatment, neurological manifestations showed a complete recovery in 16 patients (47.1%), partial in 11 (32.4%), and stationary course was found in 7 (20.6%). Manifestations of ≤4 weeks in duration carried an improved outcome compared with longer time compression, with a complete recovery in 78.6%, versus 25% for patients with a longer symptom duration (P=0.008). The upfront treatment, patient age and site of the primary tumor did not significantly affect the neurological outcome. Spinal cord compression in NB can be effectively managed with upfront chemotherapy. Initial surgical decompression should be reserved for benign variants only, including ganglioneuroma. Neurological manifestations of <4 weeks duration upon presentation are usually reversible.

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1	Prasad D and Schiff D: Malignant spinal-cord compression. Lancet Oncol. 6:15–24. 2005. View Article : Google Scholar : PubMed/NCBI
2	Brodeur GM and Maris JM: Neuroblastoma. Principles and Practice of Pediatric Oncology. Pizzo PA and Poplack DG: 5th edition. JB Lippincott Company; Philadelphia, PA: pp. 933–970. 2006
3	De Bernardi B, Balwierz W, Bejent J, et al: Epidural compression in neuroblastoma: Diagnostic and therapeutic aspects. Cancer Lett. 228:283–299. 2005. View Article : Google Scholar : PubMed/NCBI
4	Pollono D, Tomarchia S, Drut R, Ibañez O, Ferreyra M and Cédola J: Spinal cord compression: a review of 70 pediatric patients. Pediatr Hematol Oncol. 20:457–466. 2003. View Article : Google Scholar : PubMed/NCBI
5	De Bernardi B, Pianca C, Pistamiglio P, et al: Neuroblastoma with symptomatic spinal cord compression at diagnosis: treatment and results with 76 cases. J Clin Oncol. 19:183–190. 2001.PubMed/NCBI
6	Milross CG, Davies MA, Fisher R, Mameghan J and Mameghan H: The efficacy of treatment for malignant epidural spinal cord compression. Australas Radiol. 41:137–142. 1997. View Article : Google Scholar : PubMed/NCBI
7	Raffel C, Neave VC, Lavine S and McComb JG: Treatment of spinal cord compression by epidural malignancy in childhood. Neurosurgery. 28:349–352. 1991. View Article : Google Scholar : PubMed/NCBI
8	Loblaw DA and Laperriere NJ: Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline. J Clin Oncol. 16:1613–1624. 1998.PubMed/NCBI
9	Katzenstein HM, Kent PM, London WB and Cohn SL: Treatment and outcome of 83 children with intraspinal neuroblastoma: the Pediatric Oncology Group experience. J Clin Oncol. 19:1047–1055. 2001.PubMed/NCBI
10	Plantaz D, Rubie H, Michon J, et al: The treatment of neuroblastoma with intraspinal extension with chemotherapy followed by surgical removal of residual disease. A prospective study of 42 patients - results of the NBL 90 Study of the French Society of Pediatric Oncology. Cancer. 78:311–319. 1996. View Article : Google Scholar : PubMed/NCBI
11	Yiin JJ, Chang CS, Jan YJ and Wang YC: Treatment of neuroblastoma with intraspinal extensions. J Clin Neurosci. 10:579–583. 2003. View Article : Google Scholar : PubMed/NCBI
12	Bouffet E, Marec-Berard P, Thiesse P, et al: Spinal cord compression by secondary epi- and intradural metastases in childhood. Childs Nerv Syst. 13:383–387. 1997. View Article : Google Scholar : PubMed/NCBI
13	Siegal T: Spinal cord compression: from laboratory to clinic. Eur J Cancer. 31A:1748–1753. 1995. View Article : Google Scholar : PubMed/NCBI
14	Yalamanchili M and Lesser GJ: Malignant spinal cord compression. Curr Treat Options Oncol. 4:509–516. 2003. View Article : Google Scholar : PubMed/NCBI
15	Sørensen S, Helweg-Larsen S, Mouridsen H and Hansen HH: Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial. Eur J Cancer. 30A:22–27. 1994. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Intraspinal neuroblastoma: Treatment options and neurological outcome of spinal cord compression

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