Highlights
- •The association of SCI with cancer is infrequent but its recognition is clinically relevant.
- •Cancer-associated SCI affects mainly to men in the seventh decade.
- •The most frequent neoplasm associated to SCI is intravascular large B-cell lymphoma.
- •Up to 83% of the patients die in the first year after the diagnosis.
- •Age, CVRF or previously known cancer are not statistically associated with a higher mortality.
Abstract
Objective
The association between spinal cord infarction (SCI) and cancer is an infrequent condition
but requires an accurate diagnosis to establish the appropriate treatment. Clinical
features and prognosis of cancer-associated SCI have never been assessed. The aim
of this systematic review is to describe the characteristics and outcomes of patients
with cancer-associated SCI. Illustratively, a case of ovarian cancer-related SCI is
presented.
Material and methods
Two authors independently analysed three different bibliographic databases looking
for cancer-associated SCI case reports and case series. Data regarding age, sex, cardiovascular
risk factors (CVRF), history of known cancer, infarction localization, spinal cord
syndrome, Zalewski criteria classification, mechanism of ischemia, diagnostic tests,
treatment and functional outcome were registered. A statistical analysis was carried
out to identify factors related to mortality and survival time.
Results
A total of 48 articles met the inclusion criteria and 52 patients were identified.
The median age was 62 years. The most frequent neoplasm was intravascular large B-cell
lymphoma. The median survival time was 17.4 weeks and the cumulative probability of
survival at 12 months was 16.3%. In the group of deceased patients there was a higher
proportion of malignant neoplasms than in those who survived (94.7% vs. 5.3%, p < 0.01). There were no statistically significant differences in terms of mortality
or survival time depending on age, previously known cancer or CVRF.
Conclusion
Cancer-associated SCI entails a poor outcome. Mortality is increased in patients with
malignant neoplasm. No other prognosis factors could be identified.
Keywords
Abbreviations:
ASIA (American spinal injury association), CT (computerized tomography), CVRF (cardiovascular risk factors), IVLBCL (intravascular large B-cell lymphoma), MRC (Medical Research Council), MRI (magnetic resonance imaging), SCI (spinal cord infarction)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 04, 2023
Accepted:
January 31,
2023
Received in revised form:
December 9,
2022
Received:
September 28,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.