Surgical Versus Nonoperative Treatment of Metastatic Epidural Spinal Cord Compression

NCT ID: NCT00634426

Last Updated: 2015-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

163 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-03-31

Study Completion Date

2013-03-31

Brief Summary

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The aim of this trial is to evaluate the differences in pain relief, neurological function, quality of life and survival in patients with metastatic epidural spinal cord compression (MESCC) who are managed with a combination of surgery and radiotherapy versus radiotherapy alone.

Further we shall evaluate cost-effectiveness of the two treatment approaches.

Detailed Description

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Conditions

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Metastatic Epidural Spinal Cord Compression

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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1

De novo surgical cohort

Surgical excision of the metastatic process

Intervention Type PROCEDURE

Surgical excision of the metastatic process

2

Nonoperative treatment cohort

Radiotherapy of the metastatic spine process

Intervention Type RADIATION

Standard of care radiotherapy for patients with metastatic epidural spinal cord compression.

3

Secondary surgical treatment cohort

Surgical excision of the metastatic process

Intervention Type PROCEDURE

Surgical excision of the metastatic process

Interventions

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Surgical excision of the metastatic process

Surgical excision of the metastatic process

Intervention Type PROCEDURE

Radiotherapy of the metastatic spine process

Standard of care radiotherapy for patients with metastatic epidural spinal cord compression.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Single symptomatic metastatic epidural spinal compression at any level confirmed by MRI
* Age 18 and more
* Able and willing to give written informed consent to participate in the study
* Able to read and write English on an elementary level

Exclusion Criteria

* Multiple symptomatic spinal metastases
* Radiosensitive tumors
* Radioresistant tumors
* Primary cancer site in CNS or spine
* Poor life expectancy (\< 3 months)
* Patients with a tumor that has compressed only the cauda equina or spinal roots
* Has a recent history of substance abuse
* Is a prisoner
* Currently involved in another study
* has a disease or condition that would preclude accurate evaluation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AOSpine North America

INDUSTRY

Sponsor Role collaborator

AOSpine North America Research Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Fehlings, MD FRCSC

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Locations

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University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University and The Rothman Institute

Philadelphia, Pennsylvania, United States

Site Status

University of Texas Hospital / MD Anderson Cancer Center

Houston, Texas, United States

Site Status

West Viginia University

Morgantown, West Virginia, United States

Site Status

University of British Columbia

Vancouver, British Columbia, Canada

Site Status

Sunnybrook Health Sciences Center

Toronto, Ontario, Canada

Site Status

University of Toronto

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Sciubba DM, Petteys RJ, Dekutoski MB, Fisher CG, Fehlings MG, Ondra SL, Rhines LD, Gokaslan ZL. Diagnosis and management of metastatic spine disease. A review. J Neurosurg Spine. 2010 Jul;13(1):94-108. doi: 10.3171/2010.3.SPINE09202.

Reference Type BACKGROUND
PMID: 20594024 (View on PubMed)

Furlan JC, Chan KK, Sandoval GA, Lam KC, Klinger CA, Patchell RA, Laporte A, Fehlings MG. The combined use of surgery and radiotherapy to treat patients with epidural cord compression due to metastatic disease: a cost-utility analysis. Neuro Oncol. 2012 May;14(5):631-40. doi: 10.1093/neuonc/nos062. Epub 2012 Apr 14.

Reference Type BACKGROUND
PMID: 22505658 (View on PubMed)

Fitzpatrick D, Grabarz D, Wang L, Bezjak A, Fehlings MG, Fosker C, Rampersaud R, Wong RK. How effective is a virtual consultation process in facilitating multidisciplinary decision-making for malignant epidural spinal cord compression? Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):e167-72. doi: 10.1016/j.ijrobp.2012.03.057. Epub 2012 Jun 8.

Reference Type RESULT
PMID: 22682804 (View on PubMed)

Fisher CG, Schouten R, Versteeg AL, Boriani S, Varga PP, Rhines LD, Kawahara N, Fourney D, Weir L, Reynolds JJ, Sahgal A, Fehlings MG, Gokaslan ZL. Reliability of the Spinal Instability Neoplastic Score (SINS) among radiation oncologists: an assessment of instability secondary to spinal metastases. Radiat Oncol. 2014 Mar 4;9:69. doi: 10.1186/1748-717X-9-69.

Reference Type RESULT
PMID: 24594004 (View on PubMed)

Fisher CG, Versteeg AL, Schouten R, Boriani S, Varga PP, Rhines LD, Heran MK, Kawahara N, Fourney D, Reynolds JJ, Fehlings MG, Gokaslan ZL. Reliability of the spinal instability neoplastic scale among radiologists: an assessment of instability secondary to spinal metastases. AJR Am J Roentgenol. 2014 Oct;203(4):869-74. doi: 10.2214/AJR.13.12269.

Reference Type RESULT
PMID: 25247954 (View on PubMed)

Other Identifiers

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1011

Identifier Type: -

Identifier Source: org_study_id

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