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Metastatic prostate cancer with malignant epidural spinal cord compression (MESCC): new m...

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

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

Red Flag Origin

DefinitionMetastatic prostate cancer with malignant epidural spinal cord compression (MESCC): new motor deficit, sensory level, cauda equina syndrome, severe back pain with vertebral metastasis — prostate is the most common solid tumor cause of MESCC
Clinical directionhold
Categoryorgan-dysfunction
Shifts algorithmALGO-PROSTATE-MCRPC-1L

Trigger Logic

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

Notes

Per NCCN-PROSTATE supportive-care + EAU-PROSTATE 2024: dexamethasone 10 mg IV bolus + 4 mg q6h, MRI whole spine within 24 h, multidisciplinary surgical/RT review. Patchell criteria for surgery (single-level, ≥48 h expected survival, paraplegia <24 h). RT alone for non-surgical candidates. ADT initiation accelerates response in hormone-naïve; androgen-receptor pathway inhibitor in mCRPC. Direction HOLD on routine outpatient systemic therapy until cord stabilized. Priority 8. STUB — requires clinical co-lead signoff.

Used By

Indications