Osteosarcoma of the spine: surgical treatment and outcomes

World Journal of Surgical Oncology

Yong Teng²  Huazi Xu³  Zhiming Cui¹  Wei Zheng⁴  Wending Huang⁴  Junming Ma⁴  Quan Huang⁴  Zhipeng Wu⁴  Jianru Xiao⁴  Tielong Liu⁴  Xinghai Yang⁴  Dapeng Feng⁴ 

[1] Department of Orthopedic Surgery, Nantong First People’s Hospital, Nantong, 226001, China;Department of Orthopedic Surgery, Wulumuqi General Hospital of Lanzhou Military Command, People’s Liberation Army, Wulumuqi, 830000, China;Department of Orthopedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325027, China;Spine Center, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

关键词: Total piecemeal spondylectomy;    Total en bloc spondylectomy;    Spine;    Osteosarcoma;   

Others  :  825615
DOI  :  10.1186/1477-7819-11-89

 received in 2012-06-26, accepted in 2013-03-29,  发布年份 2013

【 摘 要 】

Background

The goal of this study was to determine whether there are correlations between various options of surgical treatment and long-term outcome for spinal osteosarcoma.

Methods

This was a retrospective review of 16 patients with spinal osteosarcoma, who underwent surgical treatment from 1999 to 2010. Seven patients were given total en bloc spondylectomy (TES), while nine received piecemeal resection (there were seven cases of total piecemeal spondylectomy, one of sagittal resection, and one of vertebrectomy). The outcome and prognosis of the patients were evaluated, grouped by surgical treatment.

Results

All 16 cases were followed for an average of 42.4 months. At follow-up, all patients noted that pain had eased or had gradually disappeared. Three months after surgery, eight patients (50.0%) had improved 1 to 2 grades in their neurological status, based on Frankel scoring. Six (37.5%) patients experienced local recurrence of the tumor, nine (56.3%) had metastases, and five (31.3%) died of the disease. Of the six patients who received a wide or marginal en bloc resection, none developed local recurrence or died from the disease. Conversely, of the ten patients who received intralesional or contaminated resections, six (60%) relapsed and five (50%) died from the disease.

Conclusions

TES, with a wide margin, should be planned for patients with osteosarcoma of the cervical and thoracolumbar spine, whenever possible. When the patients are not candidates for en bloc resection, total piecemeal spondylectomy is an appropriate choice for osteosarcoma in the mobile spine.

【 授权许可】

   
2013 Feng et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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