TY - JOUR
T1 - En bloc resection for primary and metastatic tumors of the spine
T2 - A systematic review of the literature
AU - Cloyd, Jordan M.
AU - Acosta, Frank L.
AU - Polley, Mei Yin
AU - Ames, Christopher P.
PY - 2010/8
Y1 - 2010/8
N2 - 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.
AB - 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.
KW - Chordoma
KW - En bloc resection
KW - Metastatic cancer
KW - Recurrence
KW - Spinal tumor
KW - Spondylectomy
KW - Surgical margins
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UR - http://www.scopus.com/inward/citedby.url?scp=77955000829&partnerID=8YFLogxK
U2 - 10.1227/01.NEU.0000371987.85090.FF
DO - 10.1227/01.NEU.0000371987.85090.FF
M3 - Review article
C2 - 20644431
AN - SCOPUS:77955000829
SN - 0148-396X
VL - 67
SP - 435
EP - 444
JO - Neurosurgery
JF - Neurosurgery
IS - 2
ER -