title: Decompressive surgery in combination with preoperative transcatheter arterial embolization: successful improvement of ambulatory function in renal cell carcinoma patients with metastatic extradural spinal cord compression.
abstract: We analyzed the results of direct decompressive surgery plus stabilization of the vertebrae involved (DDSS) in six non-ambulatory patients with metastatic extradural spinal cord compression (MESCC) due to renal cell carcinoma (RCC). Transcatheter arterial embolization (TAE) was performed prior to surgery to reduce intraoperative blood loss. Radiotherapy and systemic therapy, including cytokine or targeted therapy and zoledronic acid, were added to the surgery. The DDSS procedure was performed successfully in all patients, with an estimated mean blood loss of 1726 mL. After surgery, all patients regained ambulatory function within 2 months. Patients were ambulatory with the use of assisting apparatus for 4-29 months (median 10.5 months). Median overall survival time after surgery was 15 months (range 4-38 months). In conclusion, DDSS with preoperative TAE can be performed safely and significantly improves the ambulatory function of non-ambulatory RCC patients with MESCC.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Suzuki
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kuwatsuru
authors.forename: Keiji
authors.initials: K
authors.lastname: Wada
authors.forename: Motoya
authors.initials: M
authors.lastname: Kubota
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Junpei
authors.initials: J
authors.lastname: Iizuka
authors.forename: Eri
authors.initials: E
authors.lastname: Ikezawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Takagi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000556:secondary*; D002404:Catheterization; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary*