BACKGROUND: The standard treatment for @entity1745 caused by @entity5 is corticosteroids and radiotherapy. The role of surgery has not been established. We assessed the efficacy of direct decompressive surgery. METHODS: In this randomised, multi-institutional, non-blinded trial, we randomly assigned @entity1 with @entity1745 caused by @entity5 to either surgery followed by radiotherapy (n=50) or radiotherapy alone (n=51). Radiotherapy for both treatment groups was given in ten 3 Gy fractions. The primary endpoint was the ability to walk. Secondary endpoints were urinary continence, muscle strength and functional status, the need for corticosteroids and opioid analgesics, and survival time. All analyses were by intention to treat. FINDINGS: After an interim analysis the study was stopped because the criterion of a predetermined early stopping rule was met. Thus, 123 @entity1 were assessed for eligibility before the study closed and 101 were randomised. Significantly more @entity1 in the surgery group (42/50, 84%) than in the radiotherapy group (29/51, 57%) were able to walk after treatment (odds ratio 6.2 [95% CI 2.0-19.8] p=0.001). @entity1 treated with surgery also retained the ability to walk significantly longer than did those with radiotherapy alone (median 122 days vs 13 days, p=0.003). 32 @entity1 entered the study unable to walk; significantly more @entity1 in the surgery group regained the ability to walk than @entity1 in the radiation group (10/16 [62%] vs 3/16 [19%], p=0.01). The need for corticosteroids and opioid analgesics was significantly reduced in the surgical group. INTERPRETATION: Direct decompressive surgery plus postoperative radiotherapy is superior to treatment with radiotherapy alone for @entity1 with @entity1745 caused by @entity5 .

Direct decompressive surgical resection in the treatment of @entity1745 caused by XXXX : a randomised trial.

@entity5 :: ('MESH:D009369', 'Disease') :: ['metastatic cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'Patients'] @entity1745 :: ('MESH:D013117', 'Disease') :: ['spinal cord compression']
@entity5 :: (MESH:D009369,Disease) :: ['metastatic cancer']
