High-Grade Spinal Hemangioma: A National Cancer Database Analysis
Saavan Patel1, Darius Ansari1, Shashank N Patil1
1Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
World Neurosurgery
|January 18, 2021
Summary
Aggressive spinal hemangiomas treated with surgery and radiotherapy show improved survival. Early surgical resection combined with high-dose radiation may maximize outcomes for these rare vertebral tumors.
Area of Science:
- Oncology
- Neurosurgery
- Radiotherapy
Background:
- Spinal hemangiomas are common vertebral tumors, usually benign.
- Rarely, they can aggressively invade surrounding structures, necessitating complex treatment.
- Current treatment strategies for aggressive spinal hemangiomas remain controversial.
Purpose of the Study:
- To investigate survival trends in spinal hemangioma patients.
- To analyze the impact of various treatments on overall survival (OS).
- To formulate evidence-based treatment recommendations for aggressive spinal hemangiomas.
Main Methods:
- Utilized the National Cancer Database (NCDB) from 2004-2016.
- Included 102 patients with histologically confirmed spinal hemangiomas.
- Employed Cox proportional hazards models for survival analysis.
Main Results:
- Mean OS was 1.94 years.
- Decreased OS associated with advanced age (>65) and metastasis.
- Improved OS observed with surgical treatment and higher radiation doses.
Conclusions:
- Surgical resection and radiotherapy are linked to increased OS in aggressive spinal hemangiomas.
- This study represents the largest cohort analyzing aggressive vertebral hemangiomas.
- Recommends early surgical resection with adjuvant high-dose radiotherapy for optimal survival.
