Primary High-Grade Spinal Sarcomas: A Retrospective Review of 10 Cases

Area of Science:

• Oncology
• Orthopedic Surgery
• Neurosurgery

Background:

• Primary spinal sarcomas require aggressive surgical resection for improved outcomes.
• Anatomical limitations can prevent complete tumor resection, leading to poor prognoses for unresectable tumors.
• This study compares outcomes of resection with reconstruction versus non-resection management for spinal sarcomas.

Purpose of the Study:

• To compare oncological and functional outcomes in patients with primary spinal sarcomas.
• To evaluate the impact of surgical resection with reconstruction versus non-resection management.
• To assess effects on overall survival and activities of daily living, including ambulatory status.

Main Methods:

• Retrospective review of ten patients with primary spinal sarcomas (2010-2020).
• Comparison between a resection with reconstruction group (n=6) and a non-resection group (n=4).
• Evaluation of clinical variables, recurrence, metastasis, overall survival (OS), and activities of daily living (ADL). OS analyzed using Kaplan-Meier and log-rank tests.

Main Results:

• Tumor size was similar between groups (R group: 48.3 mm, N group: 48.8 mm).
• Metastasis rates were 50% in the R group and 75% in the N group.
• Five-year OS was 60% in the R group vs. 0% in the N group (p=0.23). Ambulatory function preserved in 83% of R group vs. 25% of N group.

Conclusions:

• Surgical resection with reconstruction did not show a definitive survival benefit.
• This approach was associated with superior postoperative functional outcomes.
• Resection with reconstruction may play a role in preserving ambulation and quality of life for spinal sarcoma patients.