Surgery followed by radiotherapy versus radiotherapy alone for metastatic @entity1745 from unfavorable XXXX .

@entity1 @entity1745 @entity5
PURPOSE: Despite a previously published randomized trial, controversy exists regarding the benefit of adding surgery to radiotherapy for metastatic @entity1745 (MSCC). It is thought that @entity1 with MSCC from relatively radioresistant @entity5 or @entity5 associated with poor functional outcome after radiotherapy alone may benefit from surgery. This study focuses on these @entity5 . METHODS AND MATERIALS: Data from 67 @entity1 receiving surgery plus radiotherapy (S+RT) were matched to 134 @entity1 (1:2) receiving radiotherapy alone (RT). Groups were matched for 10 factors and compared for motor function, ambulatory status, local control, and survival. Additional separate matched-pair analyses were performed for @entity1 receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS) and @entity1 receiving laminectomy (LE). RESULTS: Improvement of motor function occurred in 22% of @entity1 after S+RT and 16% after RT (p=0.25). Posttreatment ambulatory rates were 67% and 61%, respectively (p=0.68). Of nonambulatory @entity1 , 29% and 19% (p=0.53) regained ambulatory status. One-year local control rates were 85% and 89% (p=0.87). One-year survival rates were 38% and 24% (p=0.20). The matched-pair analysis of @entity1 receiving LE showed no significant differences between both therapies. In the matched-pair analysis of @entity1 receiving DDSS, improvement of motor function occurred more often after DDSS+RT than RT (28% vs. 19%, p=0.024). Posttreatment ambulatory rates were 86% and 67% (p=0.30); 45% and 18% of @entity1 regained ambulatory status (p=0.29). CONCLUSIONS: @entity1 with MSCC from an unfavorable @entity5 appeared to benefit from DDSS but not LE when added to radiotherapy in terms of improved functional outcome.
