Factors Affecting Prognosis of Patients with Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 102 Patients in a Single Center
Factors Affecting Prognosis of Patients with Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 102 Patients in a Single Center
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DOI：
10.1245/s10434-012-2707-6
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发表时间：
2013-03-01
影响因子：
3.7
通讯作者：
Xiao, Jianru
中科院分区：
文献类型：
--
作者：
Xu, Wei;Li, Xiang;Xiao, Jianru
移动的脊柱巨细胞瘤（GCT）是一种良性肿瘤，但它可能具有潜在的侵略性。由于移动的脊柱骨巨细胞瘤的发病率较低，其预后因素也存在争议，本文通过生存分析对移动的脊柱骨巨细胞瘤进行回顾性分析。无复发生存期（RFS）定义为手术日期与复发日期之间的时间间隔。采用Kaplan-Meier法估计术后RFS率。通过比例风险分析，对P值为千分之一货币符号0.1的因素进行RFS的多变量分析。千分之一货币符号的P值被认为是统计学显著性的。总共有102例移动的脊柱GCT患者被纳入本研究。平均随访期为39.9（中位数26.0，范围2-153）个月。38例患者复发。单因素和多因素分析表明，年龄小于40岁，全脊椎切除无论是整块或分段的方法，和双膦酸盐的管理是独立的有利预后因素。排除2000年以前患者的亚组分析进一步证实了我们的发现，无论是整块或分段切除整个骨间室，联合长期使用双膦酸盐，都可以显著降低移动的脊柱GCT的复发率。年龄小于40岁是移动的脊柱GCT的有利预后因素。
Giant cell tumor (GCT) of the mobile spine is a benign tumor, but it can be potentially aggressive. There is not much published information on GCT of the mobile spine as a result of rarity of the disease, and there are controversies over prognostic factors of the condition.A retrospective analysis of GCT of the mobile spine was performed by survival analysis. Recurrence-free survival (RFS) was defined as the interval between the date of surgery and the date of recurrence. The postoperative RFS rate was estimated by the Kaplan-Meier method. Factors with P values of a parts per thousand currency sign0.1 were subjected to multivariate analysis for RFS by proportional hazard analysis. P values of a parts per thousand currency sign0.5 were considered statistically significant.A total of 102 patients with GCT of the mobile spine were included in the study. The mean follow-up period was 39.9 (median 26.0, range 2-153) months. Thirty-eight patients developed recurrence. The univariate and multivariate analysis suggested that age less than 40 years, total spondylectomy either by en bloc or piecemeal method, and administration of bisphosphonate were independent favorable prognostic factors. Subgroup analysis by excluding patients before the year 2000 further confirmed our findings.The removal of the entire osseous compartment either by en bloc or piecemeal method in combination with the long-term use of bisphosphonate could significantly reduce the recurrence rate of GCT of the mobile spine. Age less than 40 years is a favorable prognostic factor for GCT in the mobile spine.