Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Department of Programming and Monitoring, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Curr Oncol. 2022 Oct 17;29(10):7842-7857. doi: 10.3390/curroncol29100620.
En bloc resection consists in the surgical removal of a vertebral tumor in a single piece with a sufficient margin, to improve survival and reduce recurrence rate. This procedure is technically demanding and correlates with a high complication rate. The purpose of this study is to investigate the risk factors for complications in en bloc resection and evaluate if benefits overcome the risks in term of overall survival. We retrospectively analyzed prospectively collected data of patients treated with en bloc resection between 1980 and 2021. Complications were classified according to SAVES-V2. Overall Survival was estimated using Kaplan-Meier method. A total of 149 patients out of 298 (50%) suffered from at least one complication. Moreover, 220 adverse events were collected (67 intraoperative, 82 early post-operative, 71 late post-operative), 54% of these were classified as grade 3 (in a severity scale from 1 to 6). Ten years overall survival was 67% (95% CI 59-74). The occurrence of relapses was associated to an increased risk of mortality with OR 3.4 (95% CI 2.1-5.5), while complications did not affect the overall survival. Despite a high complication rate, en bloc resection allows for a better control of disease and should be performed in selected patients by specialized surgeons.
整块切除术是指在外科手术中整块切除肿瘤及其周围组织，以提高生存率和降低复发率。该手术技术要求较高，相关并发症发生率也较高。本研究旨在探讨整块切除术相关并发症的危险因素，并评估在总体生存率方面，手术获益是否超过风险。我们回顾性分析了 1980 年至 2021 年间接受整块切除术治疗的患者的前瞻性收集数据。并发症根据 SAVES-V2 进行分类。采用 Kaplan-Meier 法估计总生存率。在 298 例患者中，共有 149 例（50%）至少发生了 1 种并发症。此外，共收集到 220 例不良事件（67 例术中，82 例术后早期，71 例术后晚期），其中 54%被归类为 3 级（严重程度从 1 级到 6 级）。10 年总生存率为 67%（95%CI59-74）。复发的发生与死亡率增加相关，OR3.4（95%CI2.1-5.5），而并发症并不影响总体生存率。尽管整块切除术相关并发症发生率较高，但它可以更好地控制疾病，应由专业外科医生在选择的患者中进行。
