Clinical outcomes and survivals after total en bloc spondylectomy for metastatic leiomyosarcoma in the spine

European spine journal

article

Satoshi Kato¹  Satoru Demura¹  Kazuya Shinmura¹  Noriaki Yokogawa¹  Noritaka Yonezawa¹  Takaki Shimizu¹  Norihiro Oku¹  Ryo Kitagawa¹  Hideki Murakami²  Norio Kawahara³  Katsuro Tomita¹  Hiroyuki Tsuchiya¹ 

[1] Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University;Department of Orthopaedic Surgery, Graduate School of Medical Science, Nagoya City University;Department of Orthopaedic Surgery, Kanazawa Medical University

关键词: Clinical outcome;    Leiomyosarcoma;    Spinal metastasis;    Survival;    Total en bloc spondylectomy;   

DOI  :  10.1007/s00586-020-06461-0

来源: Springer

【 摘 要 】

Leiomyosarcoma (LMS) is generally resistant to radiation and chemotherapy. Our study aimed to examine the outcomes of total en bloc spondylectomy (TES) for spinal metastatic LMS and to analyze potential factors associated with survival. This study included 10 consecutive patients who underwent TES for spinal metastatic LMS at our institute between 2005 and 2016 and were followed up at a minimum of 3 years after surgery. At the time of TES, all the 10 patients had solitary bone metastases in the spine. Seven patients had a lowered performance status (PS) with an eastern cooperative oncology group (ECOG) grade of 2 or 3 due to back pain or neurological symptoms. The cancer-specific survival (CSS) time from TES to death or last follow-up was the main endpoint. Potential factors associated with survival were evaluated using the Kaplan–Meier analysis and the log-rank test. Five patients underwent a single vertebral resection, and the other five patients underwent two or three consecutive vertebral resections. Three patients developed perioperative complications including pulmonary thromboembolism and pneumothorax. Nine patients improved or fairly maintained their PS with an ECOG grade of 1. The 1-, 3-, and 5-year CSS rates after TES were 90%, 70%, and 47%, respectively. Only postoperative disability (ECOG PS grade 3) was significantly associated with short-term survival after TES. The clinical outcomes of 10 patients who underwent TES for spinal metastatic LMS were favorable without severe complications. Postoperative disability was significantly associated with short-term survival after TES.

【 授权许可】

Unknown