Disch Alexander C, Boriani Stefano, Lazary Aron, Rhines Laurence D, Luzzati Alessandro, Gokaslan Ziya L, Fisher Charles G, Fehlings Michael G, Clarke Michelle J, Chou Dean, Germscheid Nicole M, Schaser Klaus-Dieter, Reynolds Jeremy J
University Center for Orthopedics, Trauma Surgery and Plastic Surgery, University Comprehensive Spine Center, University Hospital Carl Gustav Carus Dresden at the TU Dresden, 01307 Dresden, Germany.
I.R.C.C.S. Istituto Ortopedico Galeazzi, 20161 Milan, Italy.
Cancers (Basel). 2023 Jan 20;15(3):650. doi: 10.3390/cancers15030650.
Extradural primary spinal tumors were retrospectively analyzed from a prospective database of 1495 cases. All subjects with benign primary tumors under the age of 25 years, who were enrolled between 1990 and 2012 (Median FU was 2.4 years), were identified. Patient- and case-related characteristics were collected and statistically analyzed. Results: 161 patients (66f;95m; age 17.0 ± 4.7 years at time of diagnosis) were identified. The most common tumors were osteoblastomas = 53 (32.9%), osteoid osteomas = 45 (28.0%), and aneurysmal bone cysts = 32 (19.9%). The tumor grade, according to the Enneking Classification S1/S2/S3, was 14/73/74 (8.7/45.3/46.0%), respectively. Tumor-related pain was present in 156 (96.9%) patients. Diagnosis was achieved by biopsies in 2/3 of the cases. Spinal fixation was used in >50% of the cases. Resection was Enneking appropriate in = 100 (62.1%) of cases. Local recurrence occurred in 21 (13.1%) patients. Two patients died within a 10-year follow-up period. Conclusion: This is one of the largest international multicenter cohorts of young patients surgically treated for benign spinal tumors. The heterogenic young patient cohort presented at a mid-term follow-up without a correlation between the grade of aggressiveness in resection and local recurrence rates. Further prospective data are required to identify prognostic factors that determine oncological and functional outcomes for young patients suffering from these rare tumors.
对一个包含1495例病例的前瞻性数据库中的硬脊膜外原发性脊柱肿瘤进行了回顾性分析。确定了所有1990年至2012年期间入组的25岁以下患有良性原发性肿瘤的受试者（中位随访时间为2.4年）。收集并对患者及病例相关特征进行了统计分析。结果：共确定了161例患者（66例女性；95例男性；诊断时年龄为17.0±4.7岁）。最常见的肿瘤为成骨细胞瘤=53例（32.9%）、骨样骨瘤=45例（28.0%）和动脉瘤样骨囊肿=32例（19.9%）。根据Enneking分类S1/S2/S3，肿瘤分级分别为14/73/74例（8.7/45.3/46.0%）。156例（96.9%）患者存在肿瘤相关疼痛。2/3的病例通过活检确诊。超过50%的病例使用了脊柱内固定。100例（62.1%）病例的切除符合Enneking标准。21例（13.1%）患者出现局部复发。2例患者在10年随访期内死亡。结论：这是接受手术治疗的年轻良性脊柱肿瘤患者最大的国际多中心队列之一。该异质性年轻患者队列在中期随访时，切除的侵袭性分级与局部复发率之间无相关性。需要进一步的前瞻性数据来确定决定这些罕见肿瘤年轻患者肿瘤学和功能结局的预后因素。
