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Open Access Research

Surgical decompression improves recovery from neurological deficit and may provide a survival benefit in patients with diffuse large B-cell lymphoma-associated spinal cord compression: a case-series study

Ching-Ming Chang1, Hung-Chieh Chen2, Youngsen Yang1, Ren-Ching Wang3, Wen-Li Hwang1* and Chieh-Lin Jerry Teng145*

Author Affiliations

1 Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taiwan 160, Section 3, Chungkang Road, Taichung 40705, Taiwan

2 Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan 160, Section 3, Chungkang Road, Taichung 40705, Taiwan

3 Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan 160, Section 3, Chungkang Road, Taichung 40705, Taiwan

4 Department of Life Science, Tunghai University, Taichung, Taiwan 1727, Section 4, Taiwan Boulevard, Taichung 40704, Taiwan

5 Department of Medicine, Chung Shan Medical University, Taiwan 110, Section 1, Jianguo N. Road, Taichung 40201, Taiwan

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World Journal of Surgical Oncology 2013, 11:90  doi:10.1186/1477-7819-11-90

Published: 19 April 2013

Abstract

Background

Malignancy-associated spinal cord compression is generally treated by surgical decompression, radiotherapy or a combination of both. Since diffuse large B-cell lymphoma (DLBCL) is highly sensitive to both chemotherapy and radiotherapy, the role of surgical decompression in the treatment of DLBCL-associated spinal cord compression remains unclear. We therefore conducted a retrospective review to investigate the impact of surgical decompression on recovery from neurological deficit caused by DLBCL-associated spinal cord compression and patients’ overall survival.

Methods

Between March 2001 and September 2011, 497 newly diagnosed DLBCL patients were reviewed, and 11 cases had DLBCL-associated spinal cord compression. Six cases were treated surgically and five cases nonsurgically.

Results

The rates of complete recovery from neurological deficit were 100% (6/6) and 20% (1/5) for patients in the surgical and nonsurgical groups, respectively (P = 0.015), while the median survival for patients in the surgical and nonsurgical groups was 48.6 months and 17.8 months, respectively (P = 0.177).

Conclusions

We conclude that surgical decompression can improve recovery from neurological deficit in patients with DLBCL-associated spinal cord compression, possibly providing these patients a survival benefit.

Keywords:
Spinal cord compression; Diffuse large B-cell lymphoma; Decompression surgery