Surgical Strategy for Recurrent Giant Cell Tumor in the Thoracolumbar Spine

• Published in: Orthopaedic surgery 2024-01, Vol.16 (1), p.78-85
• Main Authors: Leng, Ao, Yang, Minglei, Sun, Haitao, Dai, Zeyu, Zhu, Zhi, Wan, Wei, Xiao, Jianru
• Format: Article
• Language: English
• Subjects: Asymptomatic; Bones; Cancer therapies; Care and treatment; Classification; Clinical; Clinical outcomes; Denosumab; Development and progression; Diseases; En bloc spondylectomy; Giant cell tumor of bone; Magnetic resonance imaging; Medical prognosis; Patients; Relapse; Risk factors; Spinal cancer; Spinal neoplasms; Surgeons; Surgery; Tumors
• ISSN: 1757-7853; 1757-7861
• DOI: 10.1111/os.13911

Objective Recurrent giant cell tumor (RGCT) of the spine represents a clinical challenge for surgeons, and the treatment strategy remains controversial. This study aims to describe the long‐term follow‐up outcomes and compare the efficacy of en bloc spondylectomy versus piecemeal spondylectomy in treating RGCT of the thoracolumbar spine. Methods A total of 32 patients with RGCT of the thoracolumbar spine treated from June 2012 to June 2019 were retrospectively reviewed. A total of 15 patients received total en bloc spondylectomy (TES) with wide or marginal margin while 17 patients received total piecemeal spondylectomy (TPS) with intralesional margin. Postoperative Eastern Cooperative Oncology Group Performance Score (ECOG‐PS), Frankel classification and recurrence‐free survival (RFS) were evaluated after surgery. Survival curves were estimated by the Kaplan–Meier method and differences were analyzed with the log‐rank test. Multivariate analysis was performed with Cox regression to identify the independent prognostic factors affecting RFS. Results During a median follow‐up of 41.9 ± 17.5 months, all patients with compromised neurologic functions exhibit significant improvement, with the mean ECOG‐PS decreasing from 1.5 ± 1.3 to 0.13 ± 0.3 (p