Abstract
Aims: To demonstrate the possibility to apply in the spine the same principles of surgical oncology adopted for primary bone tumors of the limbs. Methods: From 1-1-1992 to the end of 2001 seventy-seven primary malignant and aggressive benign bone tumors and 27 solitary metastases were treated. The primary tumors were classiþed according to Enneking oncological system and Weinstein-Boriani-Biagini surgical system. The en bloc resection were performed in 3 cervical, 34 thoracic, in 28 lumbar, in 29 thoracolumbar, and 10 in lumbosacral lesion. Reconstruction was performed, aiming to replace the resected elements of stability. Results: In 71 patients a wide margins was achieved, in 19 a marginal margin, in 14 an intralesional margin. No patients died during surgery or from surgical complications. Twenty-six patients were died for at least 1 month (1 to 71 months; average 29) All the other cases (78 patients) were followed for at least 12 months (12 to 366 months, average: 55 months). At þnal follow-up, sixty-seven (64,4%) patients were found continuous disease free ( CDF, 12 to max 366 months; average: 65 months), 6 (5.7%) with no evidence of disease ( NED 13 to 186 months; average: 93 months), 5 (4,8%) alive with disease ( AWD 12 to 75 months; average: 34 months); 13 local recurrence on 104 cases (12.5%) were observed and treated (6 to 126 months; average: 37 months). 4 cases developed bone metastases and 3 patients lung metastases. Conclusion: En bloc resection can be performed in selected tumors of the spine; the indication to such major surgery must be based on the oncologic stage, and the procedure must be carefully planned. For this purpose, the Weinstein-Boriani-Biagini system could be a helpful tool.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
