BACKGROUND: The efficacy of en bloc resection for spinal tumors is unknown because most of the current evidence is provided by small, single-institution clinical series or case reports. OBJECTIVE: To combine all previously published reports of en bloc resection for primary and metastatic spinal tumors, to describe the overall pattern of disease-free survival, and to investigate potentially prognostic factors for recurrence. METHODS: A complete MEDLINE search for all articles reporting survival data for en bloc resection of spinal tumors was undertaken; 44 articles met inclusion criteria from which 306 eligible patients were identified. RESULTS: There were 229 cases of primary tumors with a mean follow-up of 65.0 months and 77 cases of solitary metastatic tumors with a mean follow-up of 26.5 months. Median time to recurrence was 113 months for the primary group and 24 months for the metastatic group. Disease-free survival rates at 1, 5, and 10 years were 92.6%, 63.2%, and 43.9%, respectively, for the primary group and 61.8%, 37.5%, and 0%, respectively, for the metastatic group; 5-year disease-free survival rates were 58.4% for chordoma and 62.9% for chondrosarcoma. After adjusting for covariates, age, male sex, metastatic tumors, and osteosarcomas were significantly associated with a tumor recurrence. CONCLUSION: This study provides the largest published series of patients undergoing en bloc resection for spinal tumors. Median time to recurrence reached almost 10 years in patients with primary tumors; however, it was only 2 years in those with isolated metastatic tumors.
BACKGROUND: The efficacy of en bloc resection for spinal tumors is unknown because most of the current evidence is provided by small, single-institution clinical series or case reports. OBJECTIVE: To combine all previously published reports of en bloc resection for primary and metastatic spinal tumors, to describe the overall pattern of disease-free survival, and to investigate potentially prognostic factors for recurrence. METHODS: A complete MEDLINE search for all articles reporting survival data for en bloc resection of spinal tumors was undertaken; 44 articles met inclusion criteria from which 306 eligible patients were identified. RESULTS: There were 229 cases of primary tumors with a mean follow-up of 65.0 months and 77 cases of solitary metastatic tumors with a mean follow-up of 26.5 months. Median time to recurrence was 113 months for the primary group and 24 months for the metastatic group. Disease-free survival rates at 1, 5, and 10 years were 92.6%, 63.2%, and 43.9%, respectively, for the primary group and 61.8%, 37.5%, and 0%, respectively, for the metastatic group; 5-year disease-free survival rates were 58.4% for chordoma and 62.9% for chondrosarcoma. After adjusting for covariates, age, male sex, metastatic tumors, and osteosarcomas were significantly associated with a tumor recurrence. CONCLUSION: This study provides the largest published series of patients undergoing en bloc resection for spinal tumors. Median time to recurrence reached almost 10 years in patients with primary tumors; however, it was only 2 years in those with isolated metastatic tumors.
Authors: S Stacchiotti; A Gronchi; P Fossati; T Akiyama; C Alapetite; M Baumann; J Y Blay; S Bolle; S Boriani; P Bruzzi; R Capanna; A Caraceni; R Casadei; V Colia; J Debus; T Delaney; A Desai; P Dileo; S Dijkstra; F Doglietto; A Flanagan; S Froelich; P A Gardner; H Gelderblom; Z L Gokaslan; R Haas; C Heery; N Hindi; P Hohenberger; F Hornicek; R Imai; L Jeys; R L Jones; B Kasper; A Kawai; M Krengli; A Leithner; I Logowska; J Martin Broto; D Mazzatenta; C Morosi; P Nicolai; O J Norum; S Patel; N Penel; P Picci; S Pilotti; S Radaelli; F Ricchini; P Rutkowski; S Scheipl; C Sen; E Tamborini; K A Thornton; B Timmermann; V Torri; P U Tunn; M Uhl; Y Yamada; D C Weber; D Vanel; P P Varga; C L A Vleggeert-Lankamp; P G Casali; J Sommer Journal: Ann Oncol Date: 2017-06-01 Impact factor: 32.976