TY - JOUR
T1 - Extradural Primary Malignant Spinal Tumors in a Population Younger than 25 Years
T2 - An Ambispective International Multicenter Study on Onco-Surgical Outcomes
AU - The AO Spine Knowledge Forum Tumor
AU - Disch, Alexander C.
AU - Boriani, Stefano
AU - Luzzati, Alessandro
AU - Rhines, Laurence D.
AU - Fisher, Charles G.
AU - Lazary, Aron
AU - Gokaslan, Ziya L.
AU - Chou, Dean
AU - Clarke, Michelle J.
AU - Fehlings, Michael G.
AU - Schaser, Klaus Dieter
AU - Germscheid, Nicole M.
AU - Reynolds, Jeremy J.
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/2
Y1 - 2023/2
N2 - Extradural malignant primary spinal tumors are rare and outcome data, especially for younger patients, is limited. In a worldwide (11 centers) study (Predictors of Mortality and Morbidity in the Surgical Management of Primary Tumors of the Spine study; ClinicalTrials.gov Identifier NCT01643174) by the AO Spine Knowledge Forum Tumor, patients surgically treated for primary tumors of the spine between 1992 and 2012, were retrospectively analyzed from a prospective database of their medical history. Medical history, tumor characteristics, diagnostics, treatments, cross-sectional survival, and local recurrences were analyzed. Sixty-eight cases (32 f; 36 m), at an average age of 18.6 ± 4.7 years at the time of diagnosis, were identified (median follow-up 2.9 years). The most common entities were Ewing’s sarcoma (42.6%). Of the patients, 28% had undergone previous spine tumor surgery in another center (84% with intralesional margins). Resection was considered “Enneking appropriate” (EA) in 47.8% of the cases. Of the patients, 77.9% underwent chemotherapy and 50% radiotherapy. A local recurrence occurred in 36.4%. Over a third of patients died within a 10-year follow-up period. Kaplan-Meier-analysis demonstrated statistically significant overall survival (p = 0.007) and local recurrence rates (p = 0.042) for tumors treated with EA surgery versus Enneking inappropriate surgery. Aggressive resection of extradural primary malignant spinal tumors combined with adjuvant therapy reveals low local recurrence rates and better outcomes overall in younger patients.
AB - Extradural malignant primary spinal tumors are rare and outcome data, especially for younger patients, is limited. In a worldwide (11 centers) study (Predictors of Mortality and Morbidity in the Surgical Management of Primary Tumors of the Spine study; ClinicalTrials.gov Identifier NCT01643174) by the AO Spine Knowledge Forum Tumor, patients surgically treated for primary tumors of the spine between 1992 and 2012, were retrospectively analyzed from a prospective database of their medical history. Medical history, tumor characteristics, diagnostics, treatments, cross-sectional survival, and local recurrences were analyzed. Sixty-eight cases (32 f; 36 m), at an average age of 18.6 ± 4.7 years at the time of diagnosis, were identified (median follow-up 2.9 years). The most common entities were Ewing’s sarcoma (42.6%). Of the patients, 28% had undergone previous spine tumor surgery in another center (84% with intralesional margins). Resection was considered “Enneking appropriate” (EA) in 47.8% of the cases. Of the patients, 77.9% underwent chemotherapy and 50% radiotherapy. A local recurrence occurred in 36.4%. Over a third of patients died within a 10-year follow-up period. Kaplan-Meier-analysis demonstrated statistically significant overall survival (p = 0.007) and local recurrence rates (p = 0.042) for tumors treated with EA surgery versus Enneking inappropriate surgery. Aggressive resection of extradural primary malignant spinal tumors combined with adjuvant therapy reveals low local recurrence rates and better outcomes overall in younger patients.
KW - adolescent
KW - aggressive resection
KW - children
KW - extradural malignant primary tumor
KW - spinal tumor
KW - surgical outcome
UR - http://www.scopus.com/inward/record.url?scp=85147831510&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147831510&partnerID=8YFLogxK
U2 - 10.3390/cancers15030845
DO - 10.3390/cancers15030845
M3 - Article
C2 - 36765803
AN - SCOPUS:85147831510
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 3
M1 - 845
ER -