Primary Tumors of the Spine

Örgüç, Şebnem; Arkun, Remide

doi:10.1055/s-0034-1375570

Cited by 105 publications

(42 citation statements)

References 37 publications

(50 reference statements)

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“…We also found that there was a 3:2 predilection of males to females in EWS, which has been previously supported in smaller studies of EWS [12]. No gender predilection was found, however, in our cohort of OGS patients, despite previous literature with smaller case series citing a male predilection [23]. In terms of survival outcomes, patients with spinal OGS had a dismal overall median survival of 1.3 years, and a 5-year OS and DSS of 18% and 27%, respectively.…”

Section: Discussionsupporting

confidence: 88%

“…This association stands to reason when considering that both these malignancies are classically known to be aggressive malignancies with significant soft tissue extension, particularly in the spine [23,27]. Notably, tumor size was found to be an independent survival determinant in patients with OGS, a finding that is consistent with prior cohort studies with smaller patient pools [17].…”

Section: Discussionsupporting

confidence: 75%

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Prognostic determinants and treatment outcomes analysis of osteosarcoma and Ewing sarcoma of the spine

et al. 2017

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BACKGROUND CONTEXT Osteosarcoma (OGS) and Ewing sarcoma (EWS) are the two classic primary malignant bone tumors. Due to the rarity of these tumors, evidence on demographics, survival determinants, and treatment outcomes for primary disease of the spine are limited and derived from small case series. PURPOSE To use population-level data to determine the epidemiology and prognostic indicators in patients with OGS and EWS of the osseous spine. STUDY DESIGN/SETTING Large-scale retrospective study. PATIENT SAMPLE Patients diagnosed with OGS and EWS of the spine in the Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2012. OUTCOME MEASURES Overall survival (OS) and disease-specific survival (DSS). METHODS Two separate queries of the SEER registry were performed to identify patients with OGS and EWS of the osseous spine from 1973–2012. Study variables included age, sex, race, year of diagnosis, tumor size, extent of disease (EOD), and treatment with surgery and/or radiation therapy. Primary outcome was defined as OS and DSS in months. Univariate survival analysis was performed using the Kaplan-Meier method and the log-rank test. Multivariate analysis was performed using Cox proportional hazards regression models. RESULTS The search identified 648 patients with primary OGS and 736 patients with primary EWS of the spine from 1973 to 2012. Mean age at diagnosis was 48.1 and 19.9 years for OGS and EWS, respectively, with OGS showing a bimodal distribution. The median OS and DSS were 1.3 and 1.7 years, respectively, for OGS, with OGS in Paget’s disease having worse OS (0.7 years) relative to the mean (log-rank p=.006). The median OS and DSS for EWS were 3.9 and 4.3 years, respectively. Multivariate cox regression analysis showed that age (OS p<.001, DSS p<.001), decade of diagnosis (OS p=.049), surgical resection (OS p<.001, DSS p<.001), and EOD (OS p<.001, DSS p<.001) were independent positive prognostic indicators for spinal OGS; radiation therapy predicted worse OS (hazard ratio [HR] 1.48, confidence interval [CI] 1.05–2.10, p=.027) and DSS (HR 1.74, CI 1.13–2.66, p=.012) for OGS. For EWS, age (OS p<.001, DSS p<.001), surgical resection (OS p=.030, DSS p=.046), tumor size (OS p<.001, DSS p<.001), and EOD (OS p<.001, DSS p<.001) were independent determinants of improved survival; radiation therapy trended toward improved survival but did not achieve statistical significance for both OS (HR 0.76, CI 0.54–1.07, p=.113) and DSS (0.76, CI 0.54, 1.08, p=.126). CONCLUSIONS Age, surgical resection, and EOD are key survival determinants for both OGS and EWS of the spine. Radiation therapy may be associated with worse outcomes in patients with OGS, and is of potential benefit in EWS. Overall prognosis has improved in patients with OGS of the spine over the last four decades.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 75%

Prognostic determinants and treatment outcomes analysis of osteosarcoma and Ewing sarcoma of the spine

et al. 2017

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“…Chordomas show signal characteristics parallel to nucleus pulposus of the disk (notochord) on MR being low to intermediate signal on T1-WI (Figure 5a) and very high signal on T2-WI [19]. Coronal images on MRI demonstrate a “mushroom” appearance of the tumor (Figure 5c).…”

Section: Chordomamentioning

confidence: 99%

“…The most common location is the sacrococcygeal region, followed by the lumbar and the thoracic spine. Cervical spine involvement is rare (3.2% of patients) [19]. In the nonsacral spine, most lesions (60%) originate in the posterior elements with extension into the vertebral body [1].…”

Section: Ewing Sarcoma and Pnetmentioning

confidence: 99%

Imaging of Malignant Primitive Tumors of the Spine

Mechri¹,

Riahi²,

Sboui³

et al. 2018

Journal of the Belgian Society of Radiology

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Primary malignant tumors of the spine are rare and mainly include chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. The final diagnosis is based on the combination of patient age, topographic and histologic features of the tumor, and lesion pattern on computed tomography (CT) and magnetic resonance (MR) imaging. Imaging evaluation includes radiography, CT, bone scintigraphy, and MR imaging. CT is more useful than radiography for evaluating location of the lesion and analyzing bone destruction and matrix, whereas MR has unmatched ability to assess soft tissue extension. This pictorial review provides an overview of the most prevalent primitive malignant tumors of spine.

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“…It constitutes approximately 20% of all bone tumors in China2. GCT of the spine (SGCT) are uncommon, accounting for approximately 2%–15% of all bone GCT and approximately 16.2% of all primary tumors of the spine3, 4, 5.…”

Section: Introductionmentioning

confidence: 99%

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

Lin

Teng

et al. 2018

Orthopaedic Surgery

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ObjectiveTo review the clinical details and further treatments for recurrent spinal giant cell tumors (SGCT), and to analyze the risk factors of recurrence and shed new light on the treatment options and prognosis of recurrent SGCT.MethodsA retrospective analysis of recurrent SGCT between April 2003 and January 2014 was performed. A total of 10 patients comprising 3 men and 7 women with a mean age of 28.9 years (range, 21–40 years) were included in the study. All complete clinical data, radiographs, CT, MRI, scans and pathological data were reviewed. The tumor locations and the regions involved were evaluated by CT and MRI. The blood supply of the tumors was evaluated by enhanced CT and MRI. The mean follow‐up was 81.3 months (range, 35.7–172.1 months).ResultsAll patients had Enneking stage 3 tumors; 9 (90%) of them had different extents of spinal canal involvement in the primary time period. All patients underwent intralesional resection during their first surgery. Only 1 patient received local adjuvant treatments; no patient underwent selective arterial embolization or used denosumab at that time. Only 1 patient underwent adjuvant radiotherapy postoperatively, and another patient used bisphosphonates. After recurrence, 1 patient was cured using denosumab, and 2 patients' disease was controlled through use of other medical treatments or adjuvant treatments. There were 3 repeated recurrences and 7 repeated surgical procedures were performed in 5 patients. There were 6 intralesional excisions and 1 decompression surgery. The mean relapse‐free time after the first surgery was 32.3 months (range, 10.5–62.6 months). The overall mean relapse‐free time was 40.2 months (range, 10.5–157 months). No distant metastasis was found in our series. At the final follow‐up, 4 patients were disease free, 3 patients' disease was under control, 2 has progressive disease aggravation, while 1 patient died as a result of progression of disease 133.9 months after first surgery.ConclusionIntralesional excision for recurrent spinal giant cell tumors is an effective option that may have satisfactory prognosis. However, the excision and the inactivation of the lesion should be carried out carefully and thoroughly without missing any corners. Early diagnosis of recurrence may be associated with better prognosis. Adjuvant treatments perioperatively and systemic medical treatments can decrease recurrence rates and can have therapeutic effects in the recurrent SGCT.

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Primary Tumors of the Spine

Cited by 105 publications

References 37 publications

Prognostic determinants and treatment outcomes analysis of osteosarcoma and Ewing sarcoma of the spine

Prognostic determinants and treatment outcomes analysis of osteosarcoma and Ewing sarcoma of the spine

Imaging of Malignant Primitive Tumors of the Spine

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

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