Oncological Orthopaedics, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
Oncological Orthopedics and Reconstructive Surgery, IRCCS - Galeazzi Orthopedic Institute, Milan, Italy.
Eur Spine J. 2019 Jun;28(6):1512-1519. doi: 10.1007/s00586-019-05970-x. Epub 2019 Apr 10.
To review a series of patients > 60 years affected by primary spine bone tumors, who have undergone surgery, and to describe their clinical presentation, results and complications associated with surgical treatment.
A review of all patients > 60 years affected by primary spine bone tumor surgically treated with en bloc spondylectomy from 1993 to 2015 was performed. Thirty-seven cases were identified, and clinical and radiological characteristics, therapy, complications and survival were evaluated.
Only 14/37 cases were not previously treated. Complications were quite frequent: 64% of patients experienced almost one early complication; 48% and 27% experienced 2 and ≥ 3 early complications, respectively; 37% of patients experienced almost one late complication; and 10% and 8% experienced 2 and ≥ 3 late complications, respectively. Massive blood loss and dural tear were the more frequent surgical complications; no deaths were reported during surgeries; one patient died during the first postoperative day due to hemorrhage and cardiac complications, one during the third postoperative day for the same cause despite of a savage surgery, and another one died at 7 days from index surgery due to myocardial infarction. The 5-year disease-related survival and global survival were 62.8% and 52.1%, respectively. Nineteen patients are still alive, 15 of whom without any evidence of disease.
Primary malignant or locally aggressive bone tumors of the spine should be treated with wide surgery also in the older age, although the complications rate and the risk of patient survival can be considered high. These slides can be retrieved under Electronic Supplementary Material.
回顾一组>60 岁的原发性脊柱骨肿瘤患者，他们接受了手术治疗，并描述其临床表现、手术治疗相关结果和并发症。
对 1993 年至 2015 年期间接受整块脊柱切除术治疗的>60 岁原发性脊柱骨肿瘤患者进行回顾性分析。共发现 37 例患者，评估了他们的临床和影像学特征、治疗、并发症和生存率。
仅有 14/37 例患者未接受过先前治疗。并发症较为常见：64%的患者发生了近一种早期并发症；48%和 27%分别发生了 2 种和≥3 种早期并发症；37%的患者发生了近一种晚期并发症；10%和 8%分别发生了 2 种和≥3 种晚期并发症。大量失血和硬脊膜撕裂是较常见的手术并发症；手术过程中无死亡报告；1 例患者在术后第 1 天因出血和心脏并发症死亡，1 例患者在术后第 3 天因同样原因死亡，尽管手术野蛮，另 1 例患者在索引手术后 7 天死于心肌梗死。5 年疾病相关生存率和总生存率分别为 62.8%和 52.1%。19 例患者仍存活，其中 15 例无任何疾病证据。
即使患者的生存率和并发症风险较高，对于>60 岁的脊柱原发性恶性或局部侵袭性骨肿瘤也应采用广泛手术治疗。这些幻灯片可在电子补充材料中检索到。
