title: Surgical Outcomes and Prognostic Factors in Patients With Diffuse Large B-cell Lymphoma-associated Metastatic Spinal Cord Compression.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  The aim of this study was to discuss the factors that may affect surgical outcomes of patient with diffuse large B-cell lymphoma (DLBCL)-associated metastatic spinal cord compression (MSCC).
  
  
  BACKGROUND
  DLBCL in the spine is rare and minimal information has been published in the literature regarding this subject. Although DLBCL is highly sensitive to both chemotherapy and radiotherapy, surgical decompression is recommended in the treatment of DLBCL-associated MSCC. However, the prognostic factors affecting surgical outcomes of patients with DLBCL-associated MSCC remain unknown.
  
  
  METHODS
  We conducted a retrospective study to investigate the impact of surgical decompression on recovery from neurological deficit caused by DLBCL-associated MSCC. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival of spinal DLBCL. The survival rate was estimated by the Kaplan-Meier method, and differences were analyzed by the log-rank test. Factors with P values of 0.1 or less were subjected to multivariate analysis for survival rate by multivariate Cox proportional hazards analysis.
  
  
  RESULTS
  A total of 37 patients with spinal DLBCL from 2003 to 2014 were included in the study. International Prognostic Index (IPI) (0-1/2-5), duration of preoperative symptoms (≤2m/>2m), and lactate dehydrogenase (normal/abnormal) were suggested as the potential prognostic factors through univariate analysis. However, as they were submitted to the multivariate Cox regression model, only IPI and duration of preoperative symptoms were found as independent prognostic factors.
  
  
  CONCLUSIONS
  Surgical decompression improves recovery from neurological deficit. Patient IPI score plays an important role in decision making for surgical intervention, as it affects the length of survival and functional outcome. Patients with duration of preoperative symptoms no more than 2 months confer a very poor prognosis.
  
  
  METHODS
  4.
authors.affiliation: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.forename: Xinghai
authors.initials: X
authors.lastname: Yang
authors.forename: Dongjie
authors.initials: D
authors.lastname: Jiang
authors.forename: Wang
authors.initials: W
authors.lastname: Zhou
authors.forename: Tielong
authors.initials: T
authors.lastname: Liu
authors.forename: Wangjun
authors.initials: W
authors.lastname: Yan
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Cheng
authors.forename: Jianru
authors.initials: J
authors.lastname: Xiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000378:metabolism; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D055815:Young Adult