技术上可行的根治-手术治疗脊柱脊索瘤。

IF 4.4 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-06-14 DOI:10.3390/cancers17121989
Alexander Lars Quiring, Hraq Sarkis, Paul Backhaus, Maximilian von Oldershausen, Bernhard Meyer, Nicole Lange
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引用次数: 0

摘要

目的:在这项回顾性研究中,我们比较了阴性切缘整体切除与病灶内切除后辅助放疗对活动脊索瘤患者局部控制(LC)和总生存(OS)的影响。次要终点包括机械并发症发生率、相关危险因素和生活质量结果。方法:2008年6月至2025年3月,26例年龄≥15岁的活动脊柱(C1-L5)脊索瘤患者在我院接受手术治疗。患者分为整块切除(适当切除(EA))和病灶内切除(不适当切除(EI))加HT组。收集和分析临床、肿瘤和手术数据以确定结果。结果:EA组表现出明显的改善局部无复发生存(LRFS, EA中位35个月vs EI中位14个月)和OS的趋势。辅助治疗可获得更好的LRFS和OS,与切除程度无关。两组的临床结果和生活质量均较好,短期和长期并发症(27%)无统计学差异。没有确定长期并发症的具体危险因素。结论:在可行的情况下,整体切除仍然是活动脊索瘤切除的金标准。然而,enneking -合适的切除常常受到解剖学限制。在这种情况下,在开始辅助治疗之前,仍应尽一切努力实现最完整的肿瘤切除。由于脊索瘤的罕见性和手术复杂性,这些手术应在具有多学科专业知识的专业脊柱中心进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
As Radical as Technically Feasible-Surgical Treatment for Mobile Spine Chordoma.

Purpose: In this retrospective study, we compared the impact of en bloc resection with negative margins to that of intralesional resection followed by adjuvant radiotherapy on local control (LC) and overall survival (OS) in patients with mobile spine chordomas. Secondary endpoints included mechanical complication rates, associated risk factors, and quality of life outcomes. Methods: Between June 2008 and March 2025, 26 patients aged ≥ 15 years with mobile spine (C1-L5) chordomas underwent surgical treatment at our institution. Patients were divided into en bloc resection (=Enneking appropriate (EA)) and intralesional resection (=Enneking inappropriate (EI)) plus HT groups. Clinical, oncologic, and surgical data were collected and analyzed to determine outcomes. Results: The EA group demonstrated a clear trend toward improved local recurrence-free survival (LRFS, EA median 35 months vs. EI resection median 14 months) and OS. Adjuvant therapy led to better LRFS and OS independently of the extent of resection. Clinical outcomes and quality of life were favorable in both groups, with no statistically significant differences in short-term, as well as long-term complications (27%). No specific risk factors for long-term complications were identified. Conclusions: En bloc resection remains the gold standard for mobile spine chordoma resection whenever feasible. Nevertheless, Enneking-appropriate resection is often limited by anatomical constraints. In such cases, every effort should still be made to achieve the most complete tumor resection possible prior to initiating adjuvant therapy. Due to the rarity of spinal chordomas and their surgical complexity, these procedures should be performed in specialized spine centers with multidisciplinary expertise.

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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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