The clinical outcomes and prognostic factors of dedifferentiated central chondrosarcoma in extremities.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare no competing interests. 19. Spine (Phila Pa 1976). 2018 May 1;43(9):622-629. doi: 10.1097/BRS.0000000000002386. Ewing Sarcoma of the Spine: Prognostic Variables for Survival and Local Control in Surgically Treated Patients. Charest-Morin R(1), Dirks MS(2), Patel S(3), Boriani S(4), Luzzati A(5), Fehlings MG(6), Fisher CG(7), Dekutoski MB(8), Williams R(9), Quraishi NA(10), Gokaslan ZL(11), Bettegowda C(12), Germscheid NM(13), Varga PP(14), Rhines LD(15); AOSpine Knowledge Forum Tumor. Author information: (1)Department of Orthopaedic Surgery, Centre Hospitalier Univeristaire de Québec, Laval University, Québec, Canada. (2)Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD. (3)Department of Sarcoma Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX. (4)Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopaedic Institute, Bologna, Italy. (5)Section for Oncological Orthopaedics and Reconstruction of the Spine, IRCCS Istituto Orthopedico Galeazzi, Milan, Italy. (6)Department of Surgery, Division of Neurosurgery and Spinal Program, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. (7)Department of Orthopaedics, Division of Spine, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada. (8)Department of Orthopaedic Surgery, The CORE Institute, Sun City West, AZ. (9)Department of Orthopaedics, Princess Alexandra Hospital, Brisbane, Queensland, Australia. (10)Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom. (11)Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI. (12)Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD. (13)Research Department, AOSpine International, Davos, Switzerland. (14)National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary. (15)Department of Neurosurgery, MD Anderson Cancer Center, University of Texas, Houston, TX. STUDY DESIGN: Multicenter, ambispective observational study. OBJECTIVE: To quantify mortality and local recurrence after surgical treatment of spinal Ewing sarcoma (ES) and to determine whether an Enneking appropriate procedure and surgical margins (en bloc resection with wide/marginal margins) are associated with improved prognosis. SUMMARY OF BACKGROUND DATA: Treatment of primary ES of the spine is complex. Ambiguity remains regarding the role and optimal type of surgery in the treatment of spinal ES. METHODS: The AOSpine Knowledge Forum Tumor developed a multicenter database including demographics, diagnosis, treatment, mortality, and recurrence rate data for spinal ES. Patients were stratified based on surgical margins and Enneking appropriateness. Survival and recurrence were analyzed using Kaplan-Meier curves and log-rank tests. RESULTS: Fifty-eight patients diagnosed with primary spinal ES underwent surgery. Enneking appropriateness of surgery was known for 55 patients; 24 (44%) treated Enneking appropriately (EA) and 31 (56%) treated Enneking inappropriately (EI). A statistically significant difference in favor of EA-treated patients was found with regards to survival (P = 0.034). Neoadjuvant and postoperative chemotherapy was significantly associated with increased survival (P = 0.008). Local recurrence occurred in 22% (N = 5) of patients with an EA procedure versus 38% (N = 11) of patients with an EI procedure. The timing of chemotherapy treatment was significantly different between the Enneking cohorts (P