Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
World Neurosurg. 2020 Dec;144:e296-e305. doi: 10.1016/j.wneu.2020.08.135. Epub 2020 Aug 24.
Giant cell tumors (GCTs) constitute 5% of all primary bone tumors with spinal GCTs (SGCTs) accounting for 2%-15% of all GCTs. The standard of care for SGCT has been maximal surgical resection. However, many adjuvant therapies have been used owing to the difficulty in achieving gross total resection combined with the high local recurrence rate. The purpose of the present study was to analyze the incidence, management, and outcomes of SGCT.
Patients with diagnosis codes specific for SGCT were queried from the National Cancer Database from 2004 to 2016. The outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization.
The search criteria identified 92 patients in the NCDB dataset from 2004 to 2016 with a diagnosis of SGCT. Of the 92 patients, 64.1% had undergone surgical intervention, 24.8% had received radiotherapy, and 15.2% had received immunotherapy. Univariate analysis revealed that age ≥55 years and tumor location in the sacrum/coccyx were associated with worsened overall survival (OS) and that surgical resection was associated with improved OS. On multivariate analysis, age 55-64 years was associated with worsened OS, and radical surgical resection was associated with improved OS. The survival analysis revealed improved OS with surgery but not with radiotherapy, chemotherapy, or immunotherapy.
SGCT is a rare primary bone tumor of the vertebral column. The standard of care has been surgical resection with the goal of gross total resection; however, adjuvant therapies have often been used. Our study found that surgical resection significantly improved OS and that immunotherapy neared significance in improving OS.
巨细胞瘤（GCTs）占所有原发性骨肿瘤的 5%，其中脊柱 GCT（SGCT）占所有 GCT 的 2%-15%。SGCT 的标准治疗方法是最大限度地进行手术切除。然而，由于难以实现大体全切除，且局部复发率较高，因此许多辅助治疗方法已被应用。本研究旨在分析 SGCT 的发病率、治疗方法和结果。
从 2004 年至 2016 年，通过国家癌症数据库（NCDB）查询特定于 SGCT 的诊断代码。使用 Cox 单变量和多变量回归分析来研究结果，并生成生存曲线进行比较可视化。
搜索标准从 2004 年至 2016 年的 NCDB 数据集中确定了 92 例 SGCT 患者。在 92 例患者中，64.1%接受了手术干预，24.8%接受了放疗，15.2%接受了免疫治疗。单变量分析显示，年龄≥55 岁和肿瘤位于骶骨/尾骨与总体生存率（OS）降低相关，而手术切除与 OS 改善相关。多变量分析显示，55-64 岁年龄与 OS 降低相关，根治性手术切除与 OS 改善相关。生存分析显示，手术治疗可提高 OS，但放疗、化疗或免疫治疗则不能。
SGCT 是一种罕见的脊柱原发性骨肿瘤。标准治疗方法是手术切除，目标是实现大体全切除；然而，经常使用辅助治疗。我们的研究发现，手术切除显著提高了 OS，免疫治疗在提高 OS 方面接近显著。
