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. 2022 Sep 19;12(9):2264.
doi: 10.3390/diagnostics12092264.

Primary Bone Tumors of the Spine-Proposal for Treatment Based on a Single Centre Experience

Nicole Lange  1 , Ann-Kathrin Jörger  1 , Yu-Mi Ryang  2 , Friederike Liesche-Starnecker  3 , Jens Gempt  1 , Bernhard Meyer  1
Affiliations

Primary Bone Tumors of the Spine-Proposal for Treatment Based on a Single Centre Experience

Nicole Lange et al. Diagnostics (Basel). .

Abstract

This study reports a large single-center series of primary bone tumors of the spine (PBTs). We aimed to review the concepts for management, as this kind of tumor represents a very rare entity, and also propose a new treatment algorithm. Retrospective analysis revealed 92 patients receiving surgery for PBTs from 2007 to 2019 at our center. They were analyzed based on surgical management and the course of the disease. A total of 145 surgical procedures were performed (50 cervical, 46 thoracic, 28 lumbar, and 21 sacral). Complete tumor resection was achieved in 65%, of which 22% showed tumor recurrence during follow-up (mean time to recurrence 334 days). The five-year mortality rate was significantly lower after complete resection (3% versus 25% after subtotal resection). Most of the patients improved in their symptoms through surgery. Regarding the tumor entity, the most common PBTs were vertebral hemangiomas (20%), osteoid osteomas (15%), and chordomas (16%). The Enneking graduation system showed a good correlation with the risk of recurrence and mortality. Complete resection in PBTs increased survival rates and remains the method of choice. Thus, quality of life-especially with a higher extent of resection-should be considered.

Keywords: outcomes; primary bone tumor; treatment strategy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Tumor entities. Exact differentiation of tumor entities according to histopathological results. Total number of patients: 92. Groups divided into benign lesions (blue), semi-malignant lesions (beige), and malignant tumors (red).
Figure 2
Figure 2
Flow-chart of treatment in case of primary bone tumors.
Figure 3
Figure 3
Overall survival. Survival curves for overall survival, subdivided into subgroups of benign lesions (blue) and malignant/semi-malignant lesions (red). Curve comparison shows significant differences between curves. Log rank test of benign vs. malignant/semi-malignant lesions: X2 = 9.63, p = 0.00019.
Figure 4
Figure 4
Progression-free survival. Survival curves for progression-free survival, subdivided into the subgroups of benign lesions (blue) and malignant/semi-malignant lesions (red). Curve comparison shows significant differences between curves. Log rank test of benign vs. malignant/semi-malignant lesions: X2 = 18, p < 0.0001.
Figure 5
Figure 5
(A–C) Case descriptions.
See this image and copyright information in PMC

References

    1. Boriani S., Weinstein J.N., Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine. 1997;22:1036–1044. doi: 10.1097/00007632-199705010-00020. - DOI - PubMed
    1. Canete A.N., Bloem H.L., Kroon H.M. Primary bone tumors of the spine. Radiologia. 2016;58((Suppl. S1)):68–80. doi: 10.1016/j.rx.2016.01.001. - DOI - PubMed
    1. Erlemann R. Imaging and differential diagnosis of primary bone tumors and tumor-like lesions of the spine. Eur. J. Radiol. 2006;58:48–67. doi: 10.1016/j.ejrad.2005.12.006. - DOI - PubMed
    1. Pinter N.K., Pfiffner T.J., Mechtler L.L. Handbook of Clinical Neurology. Volume 136. Elsevier B.V.; Amsterdam, The Netherlands: 2016. Neuroimaging of spine tumors; pp. 689–706. - PubMed
    1. Patnaik S., Jyotsnarani Y., Uppin S.G., Susarla R. Imaging features of primary tumors of the spine: A pictorial essay. Indian J. Radiol. Imaging. 2016;26:279–289. doi: 10.4103/0971-3026.184413. - DOI - PMC - PubMed

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