Evidence map›Paper›PMID 36672334›Full record

ArticleCancers2023

Role of Decompressive Surgery in Neurologically Intact Patients with Low to Intermediate Intraspinal Metastatic Tumor Burden.

Niklas von Spreckelsen, Julian Ossmann, Maximilian Lenz, Lukas Nadjiri, Moritz Lenschow, Sergej Telentschak, Johanna Meyer, Julia Keßling, Peter Knöll, Peer Eysel and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Niklas von SpreckelsenDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.ORCID 0000-0002-9873-1711
Julian OssmannDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.
Maximilian LenzDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Lukas NadjiriDepartment of Radiooncology and Cyberknife Center, University of Cologne, 50937 Cologne, Germany.
Moritz LenschowDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.ORCID 0000-0003-0788-4681
Sergej TelentschakDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.
Johanna MeyerDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Julia KeßlingDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Peter KnöllDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Peer EyselDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Roland GoldbrunnerDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.
Moritz PerrechDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.
Max ScheyererDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Eren CelikDepartment of Radiooncology and Cyberknife Center, University of Cologne, 50937 Cologne, Germany.
Kourosh ZarghooniDepartment of Orthopedics and Trauma Surgery, University of Cologne, 50937 Cologne, Germany.
Volker NeuschmeltingDepartment of General Neurosurgery, Center for Neurosurgery, Cologne University Hospital, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany.
University of Cologne · DE

Funding

Deutsche Forschungsgemeinschaft 491454339
6 · The paper itself

Abstract

backgroundSurgical decompression (SD) followed by radiotherapy (RT) is superior to RT alone in patients with metastatic spinal disease with epidural spinal cord compression (ESCC) and neurological deficit. For patients without neurological deficit and low- to intermediate-grade intraspinal tumor burden, data on whether SD is beneficial are scarce. This study aims to investigate the neurological outcome of patients without neurological deficit, with a low- to intermediate-ESCC, who were treated with or without SD.

methodsThis single-center, multidepartment retrospective analysis includes patients treated for spinal epidural metastases from 2011 to 2021. Neurological status was assessed by Frankel grade, and intraspinal tumor burden was categorized according to the ESCC scale. Spinal instrumentation surgery was only considered as SD if targeted decompression was performed.

resultsESCC scale was determined in 519 patients. Of these, 190 (36.6%) presented with no neurological deficit and a low- to intermediate-grade ESCC (1b, 1c, or 2). Of these, 147 (77.4% were treated with decompression and 43 (22.65%) without. At last follow-up, there was no difference in neurological outcome between the two groups.

conclusionsIndication for decompressive surgery in neurologically intact patients with low-grade ESCC needs to be set cautiously. So far, it is unclear which patients benefit from additional decompressive surgery, warranting further prospective, randomized trials for this significant cohort of patients.

Indexed as

decompressive surgeryESCCMSCCneurological outcomespinal metastasis

Identifiers

PMID36672334
PMCPMC9857075
OpenAlexW4313827569

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.