Schneider Eleonora, Tiefenboeck Thomas M, Böhler Christoph, Noebauer-Huhmann Iris-Melanie, Lang Susanna, Krepler Petra, Funovics Philipp T, Windhager Reinhard
Division of Orthopaedics, Department of Orthopaedics and Trauma Surgery, Medical University of Vienna Waehringer Guertel, Vienna, Austria.
Division of Trauma Surgery, Department of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria.
Bone Jt Open. 2025 Feb 1;6(2):109-118. doi: 10.1302/2633-1462.62.BJO-2024-0169.R1.
The aim of the present study was to analyze the oncological and neurological outcome of patients undergoing interdisciplinary treatment for primary malignant bone and soft-tissue tumours of the spine within the last seven decades, and changes over time.
We retrospectively analyzed our single-centre experience of prospectively collected data by querying our tumour registry (Medical University of Vienna). Therapeutic, pathological, and demographic variables were examined. Descriptive data are reported for the entire cohort. Kaplan-Meier analysis and multivariate Cox regression analysis were applied to evaluate survival rates and the influence of potential risk factors.
A total of 119 consecutive patients (mean age 38 years (SD 37; 1 to 83), mean follow-up 66 months (SD 26; 0 to 505) were investigated. Histological entities included Ewing's sarcoma (EWS; 33), chondrosarcoma (CSA; 20), osteosarcoma (OSA; 22), and soft-tissue sarcoma (STS; 44). Surgery was performed in 88 patients (74%). Neurological parameters improved in 18 patients (20%) after surgery. Overall, 32 patients (36%) suffered from surgical complications requiring revision. The median survival was 42 months (IQR 10 to 204). The one-, five-, and ten-year survival rates were 73%, 47%, and 39%, respectively. Corresponding five-year survival rates for EWS, CSA, OSA, and STS were 63%, 61%, 40%, and 32%, respectively. The decade of diagnosis, histological entity, surgical intervention, resection margin, and the presence of metastases had significant influence on survival. (Neo-)adjuvant therapies alone had no significant influence on overall survival.
Our study clearly demonstrates the positive impact of improved surgical techniques, as well as refined imaging methods and evolved adjuvant therapy options, on survival rate in all tumour entities. However, despite a multimodal treatment plan, the long-term mortality of these tumours remains high.
本研究旨在分析过去七十年来接受脊柱原发性恶性骨和软组织肿瘤多学科治疗的患者的肿瘤学和神经学结局，以及随时间的变化情况。
我们通过查询肿瘤登记处（维也纳医科大学），回顾性分析了我们前瞻性收集的单中心数据。对治疗、病理和人口统计学变量进行了检查。报告了整个队列的描述性数据。应用Kaplan-Meier分析和多变量Cox回归分析来评估生存率和潜在风险因素的影响。
共调查了119例连续患者（平均年龄38岁（标准差37；1至83岁），平均随访66个月（标准差26；0至505个月）。组织学类型包括尤因肉瘤（EWS；33例）、软骨肉瘤（CSA；20例）、骨肉瘤（OSA；22例）和软组织肉瘤（STS；44例）。88例患者（74%）接受了手术。18例患者（20%）术后神经学参数得到改善。总体而言，32例患者（36%）出现需要翻修的手术并发症。中位生存期为42个月（四分位间距10至204个月）。1年、5年和10年生存率分别为73%、47%和39%。EWS、CSA、OSA和STS相应的5年生存率分别为63%、61%、40%和32%。诊断年代、组织学类型、手术干预、切缘和转移灶的存在对生存率有显著影响。单纯（新）辅助治疗对总生存率无显著影响。
我们的研究清楚地表明，改进的手术技术、完善的成像方法和不断发展的辅助治疗方案对所有肿瘤类型的生存率都有积极影响。然而，尽管采用了多模式治疗方案，这些肿瘤的长期死亡率仍然很高。
