恶性脊柱哑铃形肿瘤的临床结局及预后因素
Clinical Outcome and Prognostic Factors of Malignant Spinal Dumbbell Tumors.
作者信息
Matsumoto Yoshihiro, Kawaguchi Kenichi, Fukushi Jun-Ichi, Endo Makoto, Setsu Nokitaka, Iida Keiichiro, Baba Satoshi, Saiwai Hirokazu, Matsushita Akinobu, Hayashida Mitsumasa, Okada Seiji, Nakashima Yasuharu
机构信息
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Spine Surg Relat Res. 2018 Apr 27;2(4):317-323. doi: 10.22603/ssrr.2018-0004. eCollection 2018 Oct 26.
INTRODUCTION
To investigate the clinical outcome and prognostic factors of malignant spinal dumbbell tumors (m-SDTs).
METHODS
We retrospectively reviewed the clinical outcome of 22 consecutive cases of m-SDTs and analyzed the prognostic factors associated with worse outcome.
RESULTS
Nineteen of the 22 cases were managed with surgery (86%), and gross total resection (GTR) was achieved in four cases (21%). The duration of overall survival (OS) ranged from 3 to 140 months, with a median survival time of 15.3 months. The 5 year OS rate was 55.6%. In multivariate analysis, histological subtype (high-grade malignant peripheral nerve sheath tumor) (hazard ratio [HR] 14.9, = 0.0191), GTR (HR 0.07, = 0.0343), and presence of local recurrences (HR 11.2, = 0.0479) were significant and independent predictors of OS.
CONCLUSIONS
On the basis of clinical data, we propose that GTR and prevention of local recurrence may improve the clinical outcome of m-SDTs.
引言
探讨恶性脊柱哑铃形肿瘤（m-SDTs）的临床结局及预后因素。
方法
我们回顾性分析了连续22例m-SDTs患者的临床结局，并分析了与较差结局相关的预后因素。
结果
22例患者中有19例接受了手术治疗（86%），4例实现了全切除（GTR）（21%）。总生存期（OS）为3至140个月，中位生存时间为15.3个月。5年OS率为55.6%。多因素分析显示，组织学亚型（高级别恶性外周神经鞘瘤）（风险比[HR] 14.9，P = 0.0191）、GTR（HR 0.07，P = 0.0343）以及局部复发的存在（HR 11.2，P = 0.0479）是OS的显著且独立预测因素。
结论
基于临床数据，我们认为GTR及预防局部复发可能改善m-SDTs的临床结局。
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