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. 2022 Oct 17;29(10):7842-7857.
doi: 10.3390/curroncol29100620.

Complications and Risk Factors in En Bloc Resection of Spinal Tumors: A Retrospective Analysis on 298 Patients Treated in a Single Institution

Stefano Bandiera  1 , Luigi Emanuele Noli  1 , Cristiana Griffoni  1 , Giovanni Tosini  1 , Elisa Carretta  2 , Stefano Pasini  1 , Eleonora Pesce  1 , Alfio Damiano Ruinato  1 , Giovanni Barbanti Brodano  1 , Giuseppe Tedesco  1 , Marco Girolami  1 , Silvia Terzi  1 , Riccardo Ghermandi  1 , Gisberto Evangelisti  1 , Valerio Pipola  1 , Alessandro Gasbarrini  1
Affiliations

Complications and Risk Factors in En Bloc Resection of Spinal Tumors: A Retrospective Analysis on 298 Patients Treated in a Single Institution

Stefano Bandiera et al. Curr Oncol. .

Abstract

En bloc resection consists in the surgical removal of a vertebral tumor in a single piece with a sufficient margin, to improve survival and reduce recurrence rate. This procedure is technically demanding and correlates with a high complication rate. The purpose of this study is to investigate the risk factors for complications in en bloc resection and evaluate if benefits overcome the risks in term of overall survival. We retrospectively analyzed prospectively collected data of patients treated with en bloc resection between 1980 and 2021. Complications were classified according to SAVES-V2. Overall Survival was estimated using Kaplan-Meier method. A total of 149 patients out of 298 (50%) suffered from at least one complication. Moreover, 220 adverse events were collected (67 intraoperative, 82 early post-operative, 71 late post-operative), 54% of these were classified as grade 3 (in a severity scale from 1 to 6). Ten years overall survival was 67% (95% CI 59-74). The occurrence of relapses was associated to an increased risk of mortality with OR 3.4 (95% CI 2.1-5.5), while complications did not affect the overall survival. Despite a high complication rate, en bloc resection allows for a better control of disease and should be performed in selected patients by specialized surgeons.

Keywords: complications; en bloc resection; overall survival; spinal tumors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Adverse Events severity grade distribution. Graph shows the distribution of AEs by grades according to SAVES v2 system. “Grade 3” AEs are the most common in our cohort: 53.6% of events are likely to have a temporary effect on outcome.
Figure 2
Figure 2
Overall Survival (OS) Kaplan-Meier curves in patients with and without relapse; mo = months.
Figure 3
Figure 3
Overall Survival (OS) curves in patients with and without complications; mo = months.
Figure 4
Figure 4
Forest plot for Overall Survival in association with prognostic factors significant in the multivariable model.
Figure 5
Figure 5
Forest plot for Complications in association with prognostic factors significant in the multivariable model; y = years.
See this image and copyright information in PMC

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