Lim Jason B T, Sharma Himanshu, MacDuff Elaine, Reece Anthony T
Western Infirmary, Scottish Bone Tumour Registry, Glasgow, UK.
Acta Orthop Belg. 2013 Aug;79(4):457-62.
The authors describe 10 cases of osteosarcoma of the spine treated between January 1951 and December 2010, and obtained from the Tumour Registry of their hospital. The mean age at presentation was 38.8 years (range: 16-73 years); the mean duration of symptoms was 5.1 months (range: 3 weeks-1 year). Pain was the commonest complaint (9 patients), followed by neurological compromise (6 patients). The thoracic spine and male gender were predominant. Seven patients underwent marginal resection, 3 underwent intralesional resection. All, except one, had adjuvant chemotherapy and radiotherapy, pre- and/or postoperatively. This rare sarcoma has a dismal prognosis : the median survival period was only 23 years. The 1-year, 3-year and 5-year survival rates were 80%, 40% and 20%. Astonishingly, marginal resection (7 cases) did not lead to a longer survival than intralesional resection (3 cases): respectively 30 months and 42 months. Quite logically, local recurrence in 6 patients was linked to a survival of only 36 months, while the other 4 patients survived 52 months. Age below 40 was a positive factor, but not significantly. All patients had a reasonable quality of life with outcomes consistent with the available literature. Recent literature stresses that there is a trend toward improved survival with en bloc resection.
作者描述了1951年1月至2010年12月期间在其医院肿瘤登记处登记的10例脊柱骨肉瘤病例。就诊时的平均年龄为38.8岁（范围：16 - 73岁）；症状的平均持续时间为5.1个月（范围：3周 - 1年）。最常见的症状是疼痛（9例患者），其次是神经功能障碍（6例患者）。胸椎和男性患者居多。7例患者接受了边缘性切除，3例接受了病灶内切除。除1例患者外，所有患者在术前和/或术后均接受了辅助化疗和放疗。这种罕见的肉瘤预后不佳：中位生存期仅为23个月。1年、3年和5年生存率分别为80%、40%和20%。令人惊讶的是，边缘性切除（7例）的生存期并不比病灶内切除（3例）长：分别为30个月和42个月。很合理的是，6例局部复发患者的生存期仅为36个月，而其他4例患者存活了52个月。40岁以下是一个积极因素，但不显著。所有患者的生活质量都还不错，结果与现有文献一致。最近的文献强调，整块切除有提高生存率的趋势。
