Analysis Of Intermediate-Long Term Follow-up Of Spinal Giant Cell Tumor Operation

PurposesConduct a retrospective follow-up analysis of spinal giant cell tumor patients in recent years, Qilu Hospital of Shandong University. Evaluate treatment efficacy in order to provide experience for managing GTC patients.MethodsLarge mounts of complete clinical information were from June2005to December2013at Qilu Hospital of Shandong University.17of18patients with spinal giant cell tumor,5males and12females were collected, including three cervical lesions, seven thoracic lesions and seven lumbar cases. Frankel grading in most of patients were D or E grade. Nine cases had pathological fracture and4patients before surgery underwent target vessel embolization,1-4days ahead. Bisphosphonates therapy were given to4patient, and radiotherapy were given to5. Recoding follow-up study and treatment outcome. Drawing LRFS curves and calculate Log-Rank test and T test by Kaplan-Meier method. Using Cox analysis for multivariate analysis. All statistical data were thought to be statistically meaningful if P<0.05.ResultsAverage follow-up time was31.5months, concentrated age was between20-50years, the ratio of female to male was2.4:1. Seven people involved multiple vertebral and no concentrated vertebral was found.16patients of17patients Frankel classification came better after the operation. Embolism turned out average blood loss2475ml, blood loss in patients without embolization was averaged4200ml, independent samples T-test P=0.187, preoperative embolization related to blood loss was not statistically significant.4patients underwent postoperative bisphosphonates drug treatment, no one relapsed, independent samples T-test result was P=0.16patients underwent resection or intracapsular curettage, one patient underwent en bloc resection. Internal fixation was complete without loosening, fracture, displacement. Overall recurrence rate was29.41%, reported literature was22%-42%. No patients developed postoperative pulmonary metastasis, or other parts of transformational. The Kaplan-Meier survival analysis and Log-Rank test showed multiple vertebral tumor recurrence rate was high P=0.009<0.05. Tumor recurrence rate in patients with preoperative embolization was low P=0.046<0.05. Pathologic fractures occurred before operation had more sensorimotor disorder and dysfunction P=0.046<0.05. The Cox analysis showed that non-spinal factor related to bone giant cell tumor recurrence.Conclusion1.Qilu Hospital of Shandong University had the same recurrence rate in spinal giant cell tumor.2.Multiple vertebral tumors leaded to higher recurrence rate.3.Preoperative embolization of target vessel and bisphosphonates could reduce the recurrence rate of spinal giant cell tumor.4.Preoperative embolization target may have efficiency in reducing blood loss.5.The patients with pathologic fracture could cause sensorimotor dysfunction increases.6.Cox analysis found no special factor with spinal giant cell tumor recurrence.