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NSCLC with malignant epidural spinal cord compression (MESCC): new motor deficit, sensory...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-NSCLC-CORD-COMPRESSION
TypeRed flag
Statusreviewed 2026-04-27 | pending_clinical_signoff
DiseasesDIS-NSCLC
SourcesSRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025

Red Flag Origin

DefinitionNSCLC with malignant epidural spinal cord compression (MESCC): new motor deficit, sensory level, bowel/bladder dysfunction, severe back pain with vertebral metastasis on imaging — neurosurgical/radiation emergency
Clinical directionhold
Categoryorgan-dysfunction
Shifts algorithmALGO-NSCLC-METASTATIC-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "spinal_cord_compression",
      "value": true
    },
    {
      "finding": "new_motor_deficit_with_back_pain",
      "value": true
    },
    {
      "finding": "vertebral_metastasis_with_canal_invasion",
      "value": true
    },
    {
      "finding": "bowel_bladder_dysfunction_acute",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Per NCCN-NSCLC + NCCN supportive-care: dexamethasone 10 mg IV bolus + 4 mg q6h, urgent MRI whole spine, neurosurgery/radiation oncology consult within 24 h. Surgical decompression + RT if surgical candidate (Patchell criteria); RT alone otherwise. Time to motor deficit ≤24 h is functional-recovery cutoff. Direction HOLD on systemic therapy until cord stabilized. Priority 8 (matches PMBCL airway). STUB — requires clinical co-lead signoff.

Used By

Indications