Survival and Recurrence Rate after Treatment for Primary Spinal Sarcomas

Abstract

ObjectiveWe have limited understanding on the presentation and survival of primary spinal sarcomas. The survival, recurrence rate, and related prognostic factors were investigated after treatment for primary sarcomas of the spine.MethodsRetrospective analysis of medical records and radiological data was done for 29 patients in whom treatment was performed due to primary sarcoma of the spine from 2000 to 2010. As for treatment method, non-radical operation, radiation therapy, and chemotherapy were simultaneously or sequentially combined. Overall survival (OS), progression free survival (PFS), ambulatory function, and pain status were analyzed. In addition, factors affecting survival and recurrence were analyzed : age (≤42 or ≥43), gender, tumor histologic type, lesion location (mobile spine or rigid spine), weakness at diagnosis, pain at diagnosis, ambulation at diagnosis, initial treatment, radiation therapy, kind of irradiation, surgery, chemotherapy and distant metastasis.ResultsMedian OS was 60 months, the recurrence rate was 79.3% and median PFS was 26 months. Patients with distant metastasis showed significantly shorter survival than those without metastasis. No factors were found to be significant relating to recurrence. Prognostic factor associated with walking ability was the presence of weakness at diagnosis.ConclusionPrimary spinal sarcomas are difficult to cure and show high recurrence rate. However, the development of new treatment methods is improving survival.

Surgery Combined with Radiotherapy to Treat Spinal Tumors: A Review of Published Reports

“…For primary tumors such as Ewing sarcoma and osteosarcoma, surgery has been combined with RT in 15 reported cases. Because primary spinal tumors are very rare and their histological type, Tomita type and susceptibility to RT vary considerably, there is no standard recommendation for using RT that is applicable to all types of primary spinal tumor. One systematic review identified several articles focusing on Ewing sarcoma; these articles recommended RT after TES .…”

“…Cho and Chang reported that the outcomes of PVP combined with multi-needle interstitial implantation of 125 I seeds in patients with osteolytic metastatic vertebral tumors appeared to be better than those of PVP combined with single-needle interstitial implantation of 125 I seeds. These superior outcomes may be the result of the greater volume of bone cement injected and the better spatial distribution of the 125 I seeds with the multi-needle treatment 68 . Zhang et al also reported combining implantation with PVP and confirmed the above conclusions 90 .…”

Spinal tumors: literature review

“…В их структуре преобладают остеосаркома, саркома Юинга и хондросаркома. Хондросаркома составляет от 7 до 12 % всех ЗНО позвоночника, остеосаркомаот 3 до 14 %, саркома Юинга -от 5 до 8 % [8].…”

Individualized assessment of risk and overall survival in patients newly diagnosed with primary osseous spinal neoplasms with synchronous distant metastasis

“…As with other common malignancies, distant metastasis (DM) was also reported to be a significant factor affecting the survival rate of patients with POSNs ( 8 ), and the occurrence of metastatic disease would greatly decrease the survival time of these patients ( 9 , 10 ). More frustratingly, these metastases usually remain asymptomatic until they progress to the point of destroying the organ function and are therefore easily overlooked.…”