Treatment and outcome of primary aggressive giant cell tumor in the spine.

Abstract

Aggressive giant cell tumor (GCT) is an important subtype of GCT and is relatively rare in the spine. There is little published information regarding this subject. The objective of our study is to discuss prognostic factors for primary aggressive GCT in the spine. A retrospective study of patients who had primary aggressive GCT in the spine and underwent surgical treatment at our center between 2000 and 2012 was conducted. Univariate and multivariate analyses were performed to identify the factors that might affect recurrence. T test, Chi-square test and rank sum test were used to analyze a single factor for recurrence, and factors with P ≤ 0.1 were subjected to multivariate analyses by binary logistic regression analyses. P values of ≤0.05 were considered statistically significant. A total of 71 patients with primary aggressive GCT in the spine were included in the study. The mean follow-up period was 73.9 (range 23-167) months. Recurrence was detected in 24 patients after the initial surgery in our center with a recurrence rate of 33.8 %. The statistical analyses suggested that age more than 40 years, pathology grade III, total en bloc spondylectomy, and bisphosphonate treatment were independent prognostic factors for recurrence of primary aggressive GCT in the spine. Total en bloc spondylectomy together with bisphosphonate treatment could significantly decrease recurrence risk of primary aggressive GCT in the spine. Jaffe grade III was an adverse prognostic factor for recurrence, while age less than 40 years was a favorable prognostic factor.