Extradural Primary Malignant Spinal Tumors in a Population Younger than 25 Years: An Ambispective International Multicenter Study on Onco-Surgical Outcomes

Authors

Alexander C Disch
Stefano Boriani
Alessandro Luzzati
Laurence D Rhines
Charles G Fisher
Aron Lazary
Ziya L Gokaslan
Dean Chou
Michelle J Clarke
Michael G Fehlings
Klaus-Dieter Schaser
Nicole M Germscheid
Jeremy J Reynolds
The Ao Spine Knowledge Forum Tumor

Publication Date

1-30-2023

Abstract

Extradural malignant primary spinal tumors are rare and outcome data, especially for younger patients, is limited. In a worldwide (11 centers) study (Predictors of Mortality and Morbidity in the Surgical Management of Primary Tumors of the Spine study; ClinicalTrials.gov Identifier NCT01643174) by the AO Spine Knowledge Forum Tumor, patients surgically treated for primary tumors of the spine between 1992 and 2012, were retrospectively analyzed from a prospective database of their medical history. Medical history, tumor characteristics, diagnostics, treatments, cross-sectional survival, and local recurrences were analyzed. Sixty-eight cases (32 f; 36 m), at an average age of 18.6 ± 4.7 years at the time of diagnosis, were identified (median follow-up 2.9 years). The most common entities were Ewing's sarcoma (42.6%). Of the patients, 28% had undergone previous spine tumor surgery in another center (84% with intralesional margins). Resection was considered "Enneking appropriate" (EA) in 47.8% of the cases. Of the patients, 77.9% underwent chemotherapy and 50% radiotherapy. A local recurrence occurred in 36.4%. Over a third of patients died within a 10-year follow-up period. Kaplan-Meier-analysis demonstrated statistically significant overall survival (

Keywords

extradural malignant primary tumor, spinal tumor, adolescent, children, aggressive resection, surgical outcome

DOI

10.3390/cancers15030845

PMID

36765803

PMCID

PMC9913243

PubMedCentral® Posted Date

1-30-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes