Metastatic epidural spinal cord compression: update on management

Until recently, patients with metastatic epidural spinal cord compression (MESCC) were routinely treated with corticosteroids and radiotherapy (RT). However, major advances in imaging, recognition of new prognostic factors, and new techniques in RT and surgery have led to a number of management choices that need to be considered when treating a patient with MESCC. In our view, the management should be individualized taking into account many variables. We present here some of the advances we believe are among the most important. A historical background to the modern management of this condition is first presented.