共 22 条
[21]
Virkus WW, 2002, CLIN ORTHOP RELAT R, P89
Surgical management of spinal osteoblastomas
被引：20
作者：
Versteeg, Anne L.
[1
]
Dea, Nicolas
[2
]
Boriani, Stefano
[3
]
Varga, Peter P.
[4
,5
]
Luzzati, Alessandro
[6
]
Fehlings, Michael G.
[7
,8
,9
]
Bilsky, Mark H.
[10
]
Rhines, Laurence D.
[11
]
Reynolds, Jeremy J.
[12
]
Dekutoski, Mark. B.
[13
]
Gokaslan, Ziya L.
[14
]
Germscheid, Niccole M.
[15
]
Fisher, Charles G.
[16
,17
]
机构：
[1] Univ Med Ctr Utrecht, Dept Orthopaed Surg, Utrecht, Netherlands
[2] Univ Sherbrooke, Div Neurosurg, Dept Surg, Quebec City, PQ, Canada
[3] Rizzoli Inst, Unit Oncol & Degenerat Spine Surg, Bologna, Italy
[4] Natl Ctr Spinal Disorders, Budapest, Hungary
[5] Buda Hlth Ctr, Budapest, Hungary
[6] Ist Ortoped Galeazzi, Oncol Ortoped & Ricostrutt Rachide, Milan, Italy
[7] Univ Toronto, Div Neurosurg, Dept Surg, Toronto, ON, Canada
[8] Univ Toronto, Spine Program, Dept Surg, Toronto, ON, Canada
[9] Toronto Western Hosp, Toronto, ON, Canada
[10] Mem Sloan Kettering Canc Ctr, Dept Neurosurg, 1275 York Ave, New York, NY 10021 USA
[11] Univ Texas MD Anderson Canc Ctr, Dept Neurosurg, Houston, TX 77030 USA
[12] Oxford Univ Hosp NHS Trust, Spinal Div, Oxford, England
[13] CORE Inst, Phoenix, AZ USA
[14] Brown Univ, Dept Neurosurg, Warren Alpert Med Sch, Providence, RI 02912 USA
[15] AOSpine Int, Res Dept, Davos, Switzerland
[16] Univ British Columbia, Dept Orthoped, Div Spine, Vancouver, BC, Canada
[17] Vancouver Coastal Hlth, Combined Neurosurg & Orthoped Spine Program, Vancouver, BC, Canada
关键词：
osteoblastoma;
primary spine tumor;
spinal oncology;
Enneking classification;
surgical treatment;
prognostic factors;
local recurrence;
survival;
PRIMARY TUMORS;
MOBILE SPINE;
SYSTEM;
BENIGN;
CLASSIFICATIONS;
ENNEKING;
MARGINS;
D O I：
10.3171/2017.1.SPINE16788
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
OBJECTIVE Osteoblastoma is a rare primary benign bone tumor with a predilection for the spinal column. Although of benign origin, osteoblastomas tend to behave more aggressively clinically than other benign tumors. Because of the low incidence of osteoblastomas, evidence-based treatment guidelines and high-quality research are lacking, which has resulted in inconsistent treatment. The goal of this study was to determine whether application of the Enneking classification in the management of spinal osteoblastomas influences local recurrence and survival time. METHODS A multicenter database of patients who underwent surgical intervention for spinal osteoblastoma was developed by the AOSpine Knowledge Forum Tumor. Patient data pertaining to demographics, diagnosis, treatment, cross-sectional survival, and local recurrence were collected. Patients in 2 cohorts, based on the Enneking classification of the tumor (Enneking appropriate [EA] and Enneking inappropriate [EI]), were analyzed. If the final pathology margin matched the Enneking-recommended surgical margin, the tumor was classified as EA; if not, it was classified as EI. RESULTS A total of 102 patients diagnosed with a spinal osteoblastoma were identified between November 1991 and June 2012. Twenty-nine patients were omitted from the analysis because of short follow-up time, incomplete survival data, or invalid staging, which left 73 patients for the final analysis. Thirteen (18%) patients suffered a local recurrence, and 6 (8%) patients died during the study period. Local recurrence was strongly associated with mortality (relative risk 9.2; p = 0.008). When adjusted for Enneking appropriateness, this result was not altered significantly. No significant differences were found between the EA and EI groups in regard to local recurrence and mortality. CONCLUSIONS In this evaluation of the largest multicenter cohort of spinal osteoblastomas, local recurrence was found to be strongly associated with mortality. Application of the Enneking classification as a treatment guide for preventing local recurrence was not validated.
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页码：321 / 327
页数：7
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