Liu Fangzhi, Wang Ben, Liu Xiaoguang, Wu Fengliang, Zhou Hua, Dang Lei, Li Yan, Tang Yanchao, Liu Xiao, Hu Panpan, Li Zihe, Wei Feng, Liu Zhongjun
Orthopedic Department, Peking University Third Hospital, Beijing, China.
Engineering Research Center of Bone and Joint Precision Medicine, Peking University, Beijing, China.
J Orthop Surg Res. 2025 Mar 25;20(1):307. doi: 10.1186/s13018-025-05712-4.
Retrospective Cohort Study.
Chondrosarcoma of mobile spine is a rare aggressive malignant tumor and postsurgical local recurrence rates remain high. En bloc resection is currently the preferred treatment. Resection that achieves tumor-free margin removal of the tumor may enable more complete removal of tumor tissue but significantly increases the complexity and risk of surgery and results in more postoperative complications. We sought to compare surgical outcomes, complications, and prognoses between patients who underwent en bloc resection with and without intralesional removal of the tumor.
We reviewed 56 patients with spinal chondrosarcoma who underwent en bloc tumor resection and reconstructive surgery at our center between 2000 and 2024 with a minimum postoperative follow-up of 1 year. We collected and analyzed data regarding surgical procedures, complication characteristics, and local tumor control and recurrence.
We included 56 patients. Of these, 36 patients underwent the first surgery, and 20 experienced recurrences. All patients underwent en bloc tumor resection; 36 and 20 underwent intralesional and tumor-free margin resections, respectively. We recorded 83 complications; the incidence and the number of major complications were significantly higher in the tumor-free margin surgery group. Thirty patients experienced tumor recurrence and 26 patients died. Tumor-free margin en bloc resection and conventional-type chondrosarcoma were predictive factors for reduced long-term postoperative recurrence and mortality risk.
Tumor-free margin resection carries higher risks and is associated with a greater number of perioperative complications, but reduces the risk of local tumor recurrence and prolongs recurrence-free survival and overall survival, providing patients with better prognoses.
回顾性队列研究。
活动脊柱软骨肉瘤是一种罕见的侵袭性恶性肿瘤，术后局部复发率仍然很高。整块切除是目前的首选治疗方法。实现肿瘤切缘无瘤的切除可能会使肿瘤组织切除更彻底，但会显著增加手术的复杂性和风险，并导致更多术后并发症。我们试图比较整块切除且术中刮除肿瘤与未刮除肿瘤的患者的手术结果、并发症和预后。
我们回顾了2000年至2024年期间在我们中心接受整块肿瘤切除和重建手术的56例脊柱软骨肉瘤患者，术后至少随访1年。我们收集并分析了有关手术过程、并发症特征以及局部肿瘤控制和复发的数据。
我们纳入了56例患者。其中，36例患者接受了首次手术，20例出现复发。所有患者均接受了整块肿瘤切除；分别有36例和20例接受了病灶内切除和切缘无瘤切除。我们记录了83例并发症；切缘无瘤手术组的并发症发生率和严重并发症数量显著更高。30例患者出现肿瘤复发，26例患者死亡。切缘无瘤整块切除和传统型软骨肉瘤是术后长期复发和死亡风险降低的预测因素。
切缘无瘤切除风险更高，与更多围手术期并发症相关，但可降低局部肿瘤复发风险，延长无复发生存期和总生存期，为患者提供更好的预后。
