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Surgical management of spinal osteoblastomas.
Versteeg, Anne L; Dea, Nicolas; Boriani, Stefano; Varga, Peter P; Luzzati, Alessandro; Fehlings, Michael G; Bilsky, Mark H; Rhines, Laurence D; Reynolds, Jeremy J; Dekutoski, Mark B; Gokaslan, Ziya L; Germscheid, Niccole M; Fisher, Charles G.
Afiliação
  • Versteeg AL; Department of Orthopaedic Surgery, University Medical Center Utrecht, The Netherlands.
  • Dea N; Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Quebec, Canada.
  • Boriani S; Unit of Oncologic and Degenerative Spine Surgery, Rizzoli Institute, Bologna, Italy.
  • Varga PP; National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary.
  • Luzzati A; Oncologia Ortopedica e Ricostruttiva del Rachide, Istituto Ortopedico Galeazzi, Milano, Italy.
  • Fehlings MG; Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada.
  • Bilsky MH; Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Rhines LD; Department of Neurosurgery, MD Anderson Cancer Center, University of Texas, Houston, Texas.
  • Reynolds JJ; Spinal Division, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
  • Dekutoski MB; CORE Institute, Phoenix, Arizona.
  • Gokaslan ZL; Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
  • Germscheid NM; Research Department, AOSpine International, Davos, Switzerland; and.
  • Fisher CG; Division of Spine, Department of Orthopedics, University of British Columbia, and the Combined Neurosurgical and Orthopedic Spine Program at Vancouver Coastal Health, Vancouver, British Columbia, Canada.
J Neurosurg Spine ; 27(3): 321-327, 2017 Sep.
Article em En | MEDLINE | ID: mdl-28686147
OBJECTIVE Osteoblastoma is a rare primary benign bone tumor with a predilection for the spinal column. Although of benign origin, osteoblastomas tend to behave more aggressively clinically than other benign tumors. Because of the low incidence of osteoblastomas, evidence-based treatment guidelines and high-quality research are lacking, which has resulted in inconsistent treatment. The goal of this study was to determine whether application of the Enneking classification in the management of spinal osteoblastomas influences local recurrence and survival time. METHODS A multicenter database of patients who underwent surgical intervention for spinal osteoblastoma was developed by the AOSpine Knowledge Forum Tumor. Patient data pertaining to demographics, diagnosis, treatment, cross-sectional survival, and local recurrence were collected. Patients in 2 cohorts, based on the Enneking classification of the tumor (Enneking appropriate [EA] and Enneking inappropriate [EI]), were analyzed. If the final pathology margin matched the Enneking-recommended surgical margin, the tumor was classified as EA; if not, it was classified as EI. RESULTS A total of 102 patients diagnosed with a spinal osteoblastoma were identified between November 1991 and June 2012. Twenty-nine patients were omitted from the analysis because of short follow-up time, incomplete survival data, or invalid staging, which left 73 patients for the final analysis. Thirteen (18%) patients suffered a local recurrence, and 6 (8%) patients died during the study period. Local recurrence was strongly associated with mortality (relative risk 9.2; p = 0.008). When adjusted for Enneking appropriateness, this result was not altered significantly. No significant differences were found between the EA and EI groups in regard to local recurrence and mortality. CONCLUSIONS In this evaluation of the largest multicenter cohort of spinal osteoblastomas, local recurrence was found to be strongly associated with mortality. Application of the Enneking classification as a treatment guide for preventing local recurrence was not validated.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Coluna Vertebral / Osteoblastoma Tipo de estudo: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Coluna Vertebral / Osteoblastoma Tipo de estudo: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article