背景:脊髓肉瘤的治疗是复杂的,鉴于其广泛参与和高复发率。尽管人们一致认为需要以手术为核心的多学科方法,缺乏明确的临床决策指南.这项研究检查了一系列原发性脊髓肉瘤,专注于手术策略,临床结果,和生存数据,以告知和指导治疗实践。
方法:我们对2005年至2022年接受原发性脊髓肉瘤手术切除的患者进行了回顾性分析。这项研究的重点是收集患者人口统计数据,手术细节,术后并发症,整体住院时间,术后90天内死亡率。
结果:该研究包括14例初步诊断为脊髓肉瘤的患者,平均年龄48.6±12.6岁。软骨肉瘤是最常见的肿瘤类型,占57.1%的病例,尤因肉瘤占35.7%,滑膜肉瘤占7.1%。软骨肉瘤患者接受整块切除治疗,而滑膜肉瘤患者接受了病灶内切除术,尤因肉瘤患者接受了减压和肿瘤切除。术后评估显示神经系统状况有了显着改善。值得注意的是,通过Karnofski性能指标(KPI)衡量的功能状态,术后显著改善(从61.4%提高到80.0%)平均随访34.9±9.2个月.在此期间,一名患者在涉及腔静脉的整块切除并发症后经历了致命的出血。没有患者需要进一步手术。
结论:我们16年的研究提供了治疗原发性脊髓肉瘤的重要见解,展示手术干预的有效性,特别是整块切除。尽管它们的稀有性和复杂性,我们的多学科治疗方法改善了结局,并突出了在这一具有挑战性的领域,完善的手术策略成为标准化护理的潜力.
BACKGROUND: The management of spinal sarcomas is complex, given their widespread involvement and high recurrence rates. Despite consensus on the need for a multidisciplinary approach with surgery at its core, there is a lack of definitive guidelines for clinical decision-making. This study examines a
case series of primary spinal sarcomas, focusing on the surgical strategies, clinical results, and survival data to inform and guide therapeutic practices.
METHODS: We conducted a retrospective analysis of patients who underwent surgical resection for primary spinal sarcomas between 2005 and 2022. The study focused on gathering data on patient demographics, surgical details, postoperative complications, overall hospital stay, and mortality within 90 days post-surgery.
RESULTS: The study included 14 patients with a primary diagnosis of spinal sarcoma, with an average age of 48.6 ± 12.6 years. Chondrosarcoma emerged as the most common tumor type, representing 57.1% of cases, followed by Ewing sarcoma at 35.7%, and synovial sarcoma at 7.1%. Patients with chondrosarcoma were treated with en-bloc resection, while the patient with synovial sarcoma underwent intra-lesional excision and those with Ewing sarcoma received decompression and tumor debulking. Postoperative assessments revealed significant improvements in neurological conditions. Notably, functional status as measured by the Karnofski Performance Index (KPI), improved substantially post-surgery (from 61.4 to 80.0%) The mean follow-up was 34.9 ± 9.2 months. During this time period one patient experienced fatal bleeding after en-bloc resection complications involving the vena cava. None of the patient needed further surgery.
CONCLUSIONS: Our 16-year study offers vital insights into managing primary spinal sarcomas, showcasing the effectiveness of surgical intervention, particularly en-bloc resection. Despite their rarity and complexity, our multidisciplinary treatment approach yields improved outcomes and highlights the potential for refined surgical strategies to become standardized care in this challenging domain.