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. 1991 Jan;63(1):126–129. doi: 10.1038/bjc.1991.25

Non-Hodgkin's lymphoma presenting with extradural spinal cord compression: functional outcome and survival.

R A Eeles 1, P O'Brien 1, A Horwich 1, M Brada 1
PMCID: PMC1971629  PMID: 1989650

Abstract

Between 1971 and 1988, 20 patients with previously undiagnosed non-Hodgkin's lymphoma (NHL), of intermediate or high grade histology presented with extradural spinal cord compression. All had decompressive surgery. The first treatment after surgery was chemotherapy in nine and radiotherapy in 11 patients. At presentation 15% were ambulant and this improved to 55% after surgery; urinary continence improved from 30 to 80%. Mobility and sphincter control remained unchanged, regardless of subsequent therapy. Chemotherapy as the initial treatment modality after surgery, either alone or in combination with radiotherapy, did not jeopardise functional outcome. Mobility after surgery was an independent prognostic factor for survival, when corrected for age and stage at presentation (P = 0.04). The treatment of intermediate and high grade NHL presenting with spinal cord compression should be based on histology, extent of disease and age, as with other sites of presentation, but should also take into consideration the prognostic importance of post-surgical mobility.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Black P. Spinal metastasis: current status and recommended guidelines for management. Neurosurgery. 1979 Dec;5(6):726–746. doi: 10.1227/00006123-197912000-00016. [DOI] [PubMed] [Google Scholar]
  2. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  3. Friedman M., Kim T. H., Panahon A. M. Spinal cord compression in malignant lymphoma. Treatment and results. Cancer. 1976 Mar;37(3):1485–1491. doi: 10.1002/1097-0142(197603)37:3<1485::aid-cncr2820370334>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  4. Horwich A., Catton C. N., Quigley M., Easton D., Brada M. The management of early-stage aggressive non-Hodgkin's lymphoma. Hematol Oncol. 1988 Oct-Dec;6(4):291–298. doi: 10.1002/hon.2900060404. [DOI] [PubMed] [Google Scholar]
  5. Horwich A., Peckham M. "Bad risk" non-Hodgkin lymphomas. Semin Hematol. 1983 Jan;20(1):35–56. [PubMed] [Google Scholar]
  6. IRVINE R. A., ROBERTSON W. B. SPINAL-CORD COMPRESSION IN THE MALIGNANT LYMPHOMAS. Br Med J. 1964 May 23;1(5394):1354–1356. doi: 10.1136/bmj.1.5394.1354. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jones S. E., Miller T. P., Connors J. M. Long-term follow-up and analysis for prognostic factors for patients with limited-stage diffuse large-cell lymphoma treated with initial chemotherapy with or without adjuvant radiotherapy. J Clin Oncol. 1989 Sep;7(9):1186–1191. doi: 10.1200/JCO.1989.7.9.1186. [DOI] [PubMed] [Google Scholar]
  8. Kaminski M. S., Coleman C. N., Colby T. V., Cox R. S., Rosenberg S. A. Factors predicting survival in adults with stage I and II large-cell lymphoma treated with primary radiation therapy. Ann Intern Med. 1986 Jun;104(6):747–756. doi: 10.7326/0003-4819-104-6-747. [DOI] [PubMed] [Google Scholar]
  9. Longo D. L., Glatstein E., Duffey P. L., Ihde D. C., Hubbard S. M., Fisher R. I., Jaffe E. S., Gilliom M., Young R. C., DeVita V. T., Jr Treatment of localized aggressive lymphomas with combination chemotherapy followed by involved-field radiation therapy. J Clin Oncol. 1989 Sep;7(9):1295–1302. doi: 10.1200/JCO.1989.7.9.1295. [DOI] [PubMed] [Google Scholar]
  10. Mullins G. M., Flynn J. P., el-Mahdi A. M., McQueen J. D., Owens A. H., Jr Malignant lymphoma of the spinal epidural space. Ann Intern Med. 1971 Mar;74(3):416–423. doi: 10.7326/0003-4819-74-3-416. [DOI] [PubMed] [Google Scholar]
  11. Oviatt D. L., Kirshner H. S., Stein R. S. Successful chemotherapeutic treatment of epidural compression in non-Hodgkin's lymphoma. Cancer. 1982 Jun 15;49(12):2446–2448. doi: 10.1002/1097-0142(19820615)49:12<2446::aid-cncr2820491204>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  12. Pui C. H., Dahl G. V., Hustu H. O., Murphy S. B. Epidural spinal cord compression as the initial finding in childhood acute leukemia and non-Hodgkin lymphoma. J Pediatr. 1985 May;106(5):788–792. doi: 10.1016/s0022-3476(85)80357-7. [DOI] [PubMed] [Google Scholar]
  13. Rubin P. Extradural spinal cord compression by tumor. I. Experimental production and treatment trials. Radiology. 1969 Dec;93(6):1243–1248. doi: 10.1148/93.6.1243. [DOI] [PubMed] [Google Scholar]
  14. Sutcliffe S. B., Gospodarowicz M. K., Bush R. S., Brown T. C., Chua T., Bean H. A., Clark R. M., Dembo A., Fitzpatrick P. J., Peters M. V. Role of radiation therapy in localized non-Hodgkin's lymphoma. Radiother Oncol. 1985 Nov;4(3):211–223. doi: 10.1016/s0167-8140(85)80086-4. [DOI] [PubMed] [Google Scholar]
  15. Yarnold J. R., Horwich A., Duchesne G., Westbrook K., Gibbs J. E., Peckham M. J. Chemotherapy and radiotherapy for advanced testicular non-seminoma. I. The influence of sequence and timing of drugs and radiation on the appearance of normal tissue damage. Radiother Oncol. 1983 Nov;1(2):91–99. doi: 10.1016/s0167-8140(83)80012-7. [DOI] [PubMed] [Google Scholar]

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