Abstract
Objective To investigate the prognostic factors of giant cell tumor of bone (GCTB) in the mobile spine.Methods A retrospective analysis of GCTB in mobile spine from January 2000 to November 2010 was conducted.A total of 85 patients were included in the study,including 27 males and 58 females.The average age was 33.0± 11.7 years (range,11-65 years).60 patients admitted in our hospital with primary GCTB,and 25 patients with recurrent GCTB which was operated in other hospitals.33 patients were admitted with a Frankle score of A-C grade,and 52 patients were D-E grade.70 cases were classified as stage Ⅰ,and 15 cases as stage Ⅱ-Ⅲ in Jaffe pathologic grading system.The surgical strategies were determined according to Weinstein-Boriani-Biagini (WBB) and Enneking grading system.There were 27 cases classified as Enneking stage Ⅱ and 58 cases as stage Ⅲ.The prognostic factors were analyzed by using the method of survival analysis.Recurrence free survival (RFS) was defined as the interval between the date of surgery and the date of recurrence.The postoperative RFS rate was estimated by the Kaplan-Meier method.Factors with P values ＜ 0.1 were subjected to multivariate analysis for RFS by proportional hazard analysis.Results The mean follow-up period was 54.7 months (median 46.0 months,range 2-163 months).28 patients developed recurrence.The mean recurrent interval was 19.8 months (median 13.0 months,range 2.0-82.0 months).Univariate analysis showed that patients who received total spondylectomy had significantly better 2-year,3-year and overall RFS.Patients received bisphosphonate therapies were found to share better 2 year,5 year and overall RFS; RFS by age was significantly decreased in patients older than 40 years.The multivariate analysis suggested that total spondylectomy,bisphosphonate treatment and age less than 40 years were independent favorable prognostic factors.Conclusion The removal of the entire osseous compartment either by en bloc or piecemeal method in combination with the long-term usage of bisphosphonate could significantly reduce the recurrence rate of GCTB of the mobile spine.Age less than 40 years is a faverable prognostic factor for GCTB in the mobile spine. Key words: Spine; Giant cell tumor of bone; Diphosphonates
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