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脊柱恶性骨巨细胞瘤的治疗与预后

Treatment and outcome of malignant giant cell tumor in the spine.

作者信息

Yin Huabin, Cheng Mo, Li Bo, Li Binbin, Wang Peng, Meng Tong, Wang Jing, Zhou Wang, Yan Wangjun, Xiao Jianru

机构信息

Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Department of Orthopedics, 149 Hospital, Lianyungang, Jiangsu, China.

出版信息

J Neurooncol. 2015 Sep;124(2):275-81. doi: 10.1007/s11060-015-1835-9. Epub 2015 Jun 4.

Abstract

Malignant giant cell tumor (MGCT) in the spine is extremely rare and there is little published information regarding this subject in the literature. We attempted to correlate different treatment options and outcomes over time. A retrospective study of patients with spinal MGCT who were surgically treated in our center between 2006 and 2012 was performed. Overall, three surgical management strategies, including subtotal resection, piecemeal total resection, and total en bloc spondylectomy were applied. Postoperative radiotherapy was carried out in 4 cases. Clinical data and efficacy of surgical treatment strategy were analyzed via chart review. A total of 14 patients with spinal MGCT were included in the study. Three cases were diagnosed as primary MGCT (PMGCT), while the other 11 patients were secondary MGCT (SMGCT). The mean follow-up period was 41 (range 3-75) months. Recurrence was found in 7 patients after surgery in our center, while distant metastasis and death occurred in 4 and 6 cases, respectively. MGCT of bone is always a high-grade sarcoma with a poor prognosis and complete excision, while also preserving neural function, is recommended. In our study, patients who underwent total en bloc spondylectomy had significantly lower local recurrence rate for MGCT in the spine.

摘要

脊柱恶性巨细胞瘤(MGCT)极为罕见,文献中关于该主题的公开信息很少。我们试图关联不同的治疗方案及其随时间的结果。对2006年至2012年期间在我们中心接受手术治疗的脊柱MGCT患者进行了一项回顾性研究。总体而言,应用了三种手术管理策略,包括次全切除、分块全切除和整块全脊椎切除术。4例患者术后进行了放疗。通过病历审查分析手术治疗策略的临床数据和疗效。本研究共纳入14例脊柱MGCT患者。3例被诊断为原发性MGCT(PMGCT),其余11例为继发性MGCT(SMGCT)。平均随访期为41(范围3 - 75)个月。在我们中心,7例患者术后出现复发,4例发生远处转移,6例死亡。骨MGCT始终是一种预后不良的高级别肉瘤,建议在保留神经功能的同时进行完整切除。在我们的研究中,接受整块全脊椎切除术的患者脊柱MGCT的局部复发率显著较低。

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