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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2024

Open Access 01-12-2024 | Chondrosarcoma | Research

Complications and local recurrence of chondrosarcoma and chordoma treated by total tumor resection in thoracic and lumbar spine

Authors: Jiacheng Liu, Panpan Hu, Zhongjun Liu, Feng Wei

Published in: BMC Musculoskeletal Disorders | Issue 1/2024

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Abstract

Background

En bloc resection of spinal tumors is challenging and associated with a high incidence of complications; however, it offers the potential to reduce the risk of recurrence when a wide margin is achieved. This research aims to investigate the safety and efficacy of en bloc resection in treating thoracic and lumbar chondrosarcoma/chordoma.

Methods

Data from patients diagnosed with chondrosarcoma and chordoma in the thoracic or lumbar region, who underwent total en bloc or piecemeal resection at our institution over a 7-year period, were collected and regularly followed up. The study analyzed overall perioperative complications and compared differences in complications and local tumor recurrence between the two surgical methods.

Results

Seventeen patients were included, comprising 12 with chondrosarcoma and 5 with chordoma. Among them, 5 cases underwent intralesional piecemeal resection, while the remaining 12 underwent planned en bloc resection. The average surgical time was 684 min (sd = 287), and the mean estimated blood loss was 2300 ml (sd = 1599). Thirty-five complications were recorded, with an average of 2.06 perioperative complications per patient. 82% of patients (14/17) experienced at least one perioperative complication, and major complications occurred in 64.7% (11/17). Five patients had local recurrence during the follow-up, with a mean recurrence time of 16.2 months (sd = 7.2) and a median recurrence time of 20 months (IQR = 12.5). Hospital stays, operation time, blood loss, and complication rates did not significantly differ between the two surgical methods. The local recurrence rate after en bloc resection was lower than piecemeal resection, although not statistically significant (P = 0.067).

Conclusions

The complication rates between the two surgical procedures were similar. Considering safety and local tumor control, en bloc resection is recommended as the primary choice for patients with chondrosarcoma/chordoma in the thoracic and lumbar regions who are eligible for this treatment.
Literature
1.
Pereira NRP, et al. Physical function and quality of Life after Resection of Mobile Spine Chondrosarcoma. Global Spine J. 2019;9(7):743–53.CrossRef
2.
Sundaresan N, Rosen G, Boriani S. Primary malignant tumors of the spine. Orthop Clin North Am. 2009;40(1):21–.CrossRefPubMed
3.
Walcott BP, et al. Chordoma: current concepts, management, and future directions. Lancet Oncol. 2012;13(2):e69–76.CrossRefPubMed
4.
Court C, et al. Management of chordoma of the sacrum and mobile spine. Orthop Traumatol Surg Res. 2022;108(1S):103169.CrossRefPubMed
5.
6.
Zuckerman SL, Bilsky MH, Laufer I. Chordomas of the Skull Base, Mobile Spine, and Sacrum: an Epidemiologic Investigation of Presentation, Treatment, and Survival. World Neurosurg. 2018;113:e618–27.CrossRefPubMed
7.
8.
Boriani S, et al. Chondrosarcoma of the mobile spine: report on 22 cases. Spine (Phila Pa 1976). 2000;25(7):804–12.CrossRefPubMed
9.
Boriani S, et al. Challenges of local recurrence and cure in low Grade Malignant tumors of the spine. Spine. 2009;34:S48–57.CrossRefPubMed
10.
Hsieh PC, et al. Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas: a series of twenty consecutive patients. Spine (Phila Pa 1976). 2009;34(20):2233–9.CrossRefPubMed
11.
York JE, et al. Chondrosarcoma of the spine: 1954 to 1997. J Neurosurg. 1999;90(1 Suppl):73–8.PubMed
12.
Pennington Z, et al. Chordoma of the sacrum and mobile spine: a narrative review. Spine J. 2021;21(3):500–17.CrossRefPubMed
13.
Shimizu T, et al. Total en bloc spondylectomy for primary tumors of the lumbar spine. Med (Baltim). 2018;97(37):e12366.CrossRef
14.
Shah AA, et al. Modified En Bloc Spondylectomy for tumors of the thoracic and lumbar spine: Surgical technique and outcomes. J Bone Joint Surg Am. 2017;99(17):1476–84.CrossRefPubMed
15.
Bandiera S, et al. Complications and risk factors in En Bloc Resection of spinal tumors: a retrospective analysis on 298 patients treated in a single Institution. Curr Oncol. 2022;29(10):7842–57.CrossRefPubMedPubMedCentral
16.
Boriani S, et al. Predictors for surgical complications of en bloc resections in the spine: review of 220 cases treated by the same team. Eur Spine J. 2016;25(12):3932–41.CrossRefPubMed
17.
Demura S, et al. Perioperative complications of total en bloc spondylectomy for spinal tumours. Bone Joint J. 2021;103–B(5):976–83.CrossRefPubMed
18.
Matsumoto M, et al. Major Complications and Sequelae after Total En Bloc Spondylectomy for malignant spinal tumors. Neurosurg Q. 2015;25(4):442–51.CrossRef
19.
Liu J, et al. Complications and prognosis of primary thoracic and lumbar giant cell tumors treated by total tumor resection. BMC Musculoskelet Disord. 2023;24(1):281.CrossRefPubMedPubMedCentral
20.
Vuong HG, Dunn IF. Chondrosarcoma and Chordoma of the Skull Base and Spine: implication of Tumor Location on Patient Survival. World Neurosurg. 2022;162:e635–9.CrossRefPubMed
21.
Chan P, et al. An assessment of the reliability of the Enneking and Weinstein-Boriani-Biagini classifications for staging of primary spinal tumors by the Spine Oncology Study Group. Spine (Phila Pa 1976). 2009;34(4):384–91.CrossRefPubMed
22.
Boriani S, Weinstein JN, Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976). 1997;22(9):1036–44.CrossRefPubMed
23.
24.
Bilsky MH, et al. Reliability analysis of the epidural spinal cord compression scale. J Neurosurg Spine. 2010;13(3):324–8.CrossRefPubMed
25.
McDonnell MF, et al. Perioperative complications of anterior procedures on the spine. J Bone Joint Surg Am. 1996;78(6):839–47.CrossRefPubMed
26.
Kawahara N, et al. Total en bloc spondylectomy of the lower lumbar spine: a surgical techniques of combined posterior-anterior approach. Spine (Phila Pa 1976). 2011;36(1):74–82.CrossRefPubMed
27.
Kawahara N, et al. Total en bloc spondylectomy for spinal tumors: surgical techniques and related basic background. Orthop Clin North Am. 2009;40(1):47–63. vi.CrossRefPubMed
28.
Nair S, et al. Preoperative embolization of hypervascular thoracic, lumbar, and sacral spinal column tumors: technique and outcomes from a single center. Interv Neuroradiol. 2013;19(3):377–85.CrossRefPubMedPubMedCentral
29.
Yokogawa N, et al. Postoperative cerebrospinal fluid leakage Associated with Total En Bloc Spondylectomy. Orthopedics. 2015;38(7):e561–6.CrossRefPubMed
30.
McLoughlin GS, Sciubba DM, Wolinsky JP. Chondroma/Chondrosarcoma of the spine. Neurosurg Clin N Am. 2008;19(1):57–63.CrossRefPubMed
31.
32.
Stieb S, et al. Long-term clinical safety of high-dose Proton Radiation Therapy Delivered with Pencil Beam scanning technique for Extracranial Chordomas and Chondrosarcomas in Adult patients: clinical evidence of spinal cord tolerance. Int J Radiat Oncol Biol Phys. 2018;100(1):218–25.CrossRefPubMed
33.
Sahgal A, et al. Image-guided, intensity-modulated radiation therapy (IG-IMRT) for skull base chordoma and chondrosarcoma: preliminary outcomes. Neuro Oncol. 2015;17(6):889–94.CrossRefPubMed
34.
35.
36.
Boriani S, et al. Chordoma of the mobile spine: fifty years of experience. Spine (Phila Pa 1976). 2006;31(4):493–503.CrossRefPubMed
37.
Metadata
Title
Complications and local recurrence of chondrosarcoma and chordoma treated by total tumor resection in thoracic and lumbar spine
Authors
Jiacheng Liu
Panpan Hu
Zhongjun Liu
Feng Wei
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2024
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-024-07353-w

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