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Open Access Highly Accessed Research

Osteosarcoma of the spine: surgical treatment and outcomes

Dapeng Feng1, Xinghai Yang1, Tielong Liu1, Jianru Xiao1*, Zhipeng Wu1, Quan Huang1, Junming Ma1, Wending Huang1, Wei Zheng1, Zhiming Cui2, Huazi Xu3 and Yong Teng4

Author Affiliations

1 Spine Center, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

2 Department of Orthopedic Surgery, Nantong First People’s Hospital, Nantong, 226001, China

3 Department of Orthopedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325027, China

4 Department of Orthopedic Surgery, Wulumuqi General Hospital of Lanzhou Military Command, People’s Liberation Army, Wulumuqi, 830000, China

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World Journal of Surgical Oncology 2013, 11:89  doi:10.1186/1477-7819-11-89

Published: 18 April 2013

Abstract

Background

The goal of this study was to determine whether there are correlations between various options of surgical treatment and long-term outcome for spinal osteosarcoma.

Methods

This was a retrospective review of 16 patients with spinal osteosarcoma, who underwent surgical treatment from 1999 to 2010. Seven patients were given total en bloc spondylectomy (TES), while nine received piecemeal resection (there were seven cases of total piecemeal spondylectomy, one of sagittal resection, and one of vertebrectomy). The outcome and prognosis of the patients were evaluated, grouped by surgical treatment.

Results

All 16 cases were followed for an average of 42.4 months. At follow-up, all patients noted that pain had eased or had gradually disappeared. Three months after surgery, eight patients (50.0%) had improved 1 to 2 grades in their neurological status, based on Frankel scoring. Six (37.5%) patients experienced local recurrence of the tumor, nine (56.3%) had metastases, and five (31.3%) died of the disease. Of the six patients who received a wide or marginal en bloc resection, none developed local recurrence or died from the disease. Conversely, of the ten patients who received intralesional or contaminated resections, six (60%) relapsed and five (50%) died from the disease.

Conclusions

TES, with a wide margin, should be planned for patients with osteosarcoma of the cervical and thoracolumbar spine, whenever possible. When the patients are not candidates for en bloc resection, total piecemeal spondylectomy is an appropriate choice for osteosarcoma in the mobile spine.

Keywords:
Osteosarcoma; Spine; Total en bloc spondylectomy; Total piecemeal spondylectomy