156 - Cervicothoracic Junction Tumors

Abstract

The cervicothoracic junction (CTJ), which describes the region between the C7 and T4 vertebrae, serves as the transitional zone between the relatively mobile and lordotic cervical spine and the more rigid and kyphotic thoracic spine. Neoplasms in this region account for approximately 15% of all spinal tumors, and although surgical resection is often necessary for their management, the unique mechanical stresses associated with this transition, combined with the presence of abundant critical vascular, neurological, and soft tissue in this region, render management of CTJ lesions challenging from both biomechanical and anatomical perspectives. As such, appropriate patient selection and preoperative planning are critical in achieving optimal postoperative outcomes. The surgical approach should be selected with potential complications and patient history of previous operations in the CTJ in mind. Although radiation therapy remains the mainstay of treatment for many patients with malignant CTJ tumors, there is growing evidence that surgery with adjuvant radiation is correlated with improved outcomes and survival. Advances such as image-guided intensity modulated radiotherapy have allowed better local tumor control in radiotherapy-resistant tumors.