Risk factors for local recurrence after total en bloc spondylectomy for metastatic spinal tumors: A retrospective study.

Abstract

The aim of this study was to evaluate local recurrence and survival outcomes after frozen autograft total en bloc spondylectomy for metastatic spinal tumors. We retrospectively analyzed data from 91 patients with metastatic spinal tumors who underwent frozen autograft total en bloc spondylectomy at our institution between May 2010 and April 2015. We assessed the incidence, primary cancer type, and sites of local recurrence. Risk factors for local recurrence were also examined through the statistical analysis of 17 items, including clinico-pathological characteristics, treatment history, and preoperative or surgical complications. Survival outcomes were evaluated with particular attention paid to the presence of local recurrence. The median follow-up duration was 27.4 months (range, 4-66 months). Local recurrence was diagnosed in 10 of 91 patients (11.0%). The sites of recurrence were intradural in 4 cases, epidural in 3 cases, in a vertebral body adjacent to the resected vertebral body in 2 cases, and in the paraspinal muscle in 3 cases. None of the patients had recurrence from the liquid nitrogen-treated tumor-bearing autograft. There were no local recurrences of renal cell carcinoma, thyroid cancer, or lung cancer. Multivariate analysis indicated that radiotherapy history was the only risk factor for local recurrence (odds ratio, 6.26; 95% confidence interval, 1.21-45.62; p=0.04). The 2-year survival rate was significantly lower for the recurrence group than for the non-recurrence group (p<0.05). A history of radiation was the only risk factor for local recurrence. Patients with recurrence had a significantly worse prognosis than those without recurrence.