What is the prognosis of spinal tumors?

Updated: Nov 01, 2018
  • Author: Andrew A Sama, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Chang et al conducted a study to evaluate local control rate and to identify prognostic factors after stereotactic radiosurgery for treatment of primary malignant spinal tumors. [2]  Median age of the 29 patients was 46 years (range, 11-68). Histologic diagnoses included chordoma (n = 1), chondrosarcoma (n = 5), osteosarcoma (n = 3), synovial sarcoma (n = 3), plasmacytoma (n = 2), Ewing sarcoma (n = 2), malignant peripheral nerve sheath tumor (n = 2), and malignant fibrous histiocytoma (n = 1). Mean follow-up was 50 months (range, 8-126).

Surgical resection was the initial treatment in 25 cases, percutaneous biopsy in four. [2]  Stereotactic radiosurgery was used as primary treatment in 14 cases and as salvage treatment for progressive lesions in 15. Eleven patients had undergone previous conventional external-beam radiation therapy before stereotactic radiosurgery. Median tumor volume was 14 cm3 (range, 2.0-235). Delivered radiation doses were 12-50 Gy in two to six sessions. The mean radiation dose converted into a biologic effective dose (BED) was 60 Gy (range, 43-105).

Mean overall survival was 84 months for chordoma patients and 104 months for sarcoma patients. [2]  The investigators found no factors that affected overall survival. The mean local progression-free survival was 56 months for chordoma patients and 73 months for sarcoma patients. The recurrent mode of presentation was predictive of local progression of spinal sarcomas. For patients with chordoma, no factors were found to correlate with local recurrence.

Kose et al conducted a study of the effect of early rehabilitation on neurofunctional outcome after surgery in children with spinal tumors. [3]  The investigators reviewed medical charts and radiographic records of 70 pediatric patients (aged 1-17 years) who underwent surgery for the removal of spinal tumor. The patients received rehabilitation treatment beginning 4 days (range, 2-7 days) after surgery for 10 days (range, 7-23 days).

Results were assessed on the basis of scoring on the Modified McCormick Scale, the Functional Independence Measure for Children, the American Spinal Injury Association Impairment Scale, and the Karnofsky Performance Status Scale. [3]  Sensory function, motor function, and activity of daily living were significantly improved for the patients who received early rehabilitation. Tumor setting, the level of localization, and the patients' clinical symptoms had no bearing on neurofunctional outcomes.


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