Multidisciplinary treatment system for bone metastases for early diagnosis, treatment and prevention of malignant spinal cord compression

Nakata,Eiji; Sugihara,Shinsuke; Sugawara,Yoshifumi; Nakahara,Ryuichi; Furumatsu,Takayuki; Tetsunaga,Tomonori; Kunisada,Toshiyuki; Nakanishi,Kazuo; Akezaki,Yoshiteru; Ozaki,Toshifumi

doi:10.3892/ol.2020.11415

Multidisciplinary treatment system for bone metastases for early diagnosis, treatment and prevention of malignant spinal cord compression

Authors:
- Eiji Nakata
- Shinsuke Sugihara
- Yoshifumi Sugawara
- Ryuichi Nakahara
- Takayuki Furumatsu
- Tomonori Tetsunaga
- Toshiyuki Kunisada
- Kazuo Nakanishi
- Yoshiteru Akezaki
- Toshifumi Ozaki
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Affiliations: Department of Orthopedic Surgery, Okayama University Hospital, Okayama 700‑8558, Japan, Department of Orthopedic Surgery, Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Radiology, Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Orthopedic Surgery, Kawasaki Medical School Hospital, Okayama 701‑0192, Japan, Division of Physical Therapy, Kochi Professional University of Rehabilitation, Tosa, Kochi 781‑1102, Japan
Published online on: February 20, 2020 https://doi.org/10.3892/ol.2020.11415
Pages: 3137-3144
Copyright: © Nakata et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Malignant spinal cord compression (MSCC) is a serious complication of cancers. The present study aimed to establish a multidisciplinary treatment system for urgent magnetic resonance imaging (MRI) and referral to orthopedists in order to prevent neurological deficits caused by MSCC. In the present study, the extent to which this system achieved early diagnosis and treatment and prevented MSCC‑caused neurological deficits was examined. The records from patients with neurological deficits caused by MSCC before (between April 2007 and March 2012; group A) and after (between April 2012 and March 2017; group B) the establishment of the multidisciplinary system at the Shikoku Cancer Center (Ehime, Japan) were retrospectively evaluated. The numbers of patients with neurological deficits were 38 and 7 in groups A and B, respectively. All patients received radiotherapy. The incidence of neurological deficits was 13.2 and 3.4% in groups A and B, respectively (P<0.001). The proportion of patients with improvement in the severity of neurological deficits was 5.3 and 28.6% in groups A and B, respectively (P<0.001). The interval between physicians' recognition of a neurological deficit and MRI and the start of treatment, the number of cases, and the severity of neurological deficits were evaluated in groups A and B. The median interval between recognition of a neurological deficit by physicians and MRI was 3 and 0 days in groups A and B, respectively (P<0.001). The median interval between physicians' recognition of a neurological deficit and the start of treatment was 3 and 0 days in groups A and B, respectively (P<0.001). By using a multidisciplinary treatment system, the incidence and severity of neurological deficits following treatment were significantly improved. Therefore, the multidisciplinary treatment system used in the present study may be useful for early diagnosis, treatment and prevention of MSCC in patients with bone metastases.

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