Purpose

Review a series of 22 patients below the age of 16 affected by primary bone tumors of the spine who underwent en bloc resection, and describe the clinical presentation, tumor characteristics, results and complications associated with the surgical treatment, underlining the specific issues related to a younger age.

Methods

We performed a review of all patients < 16 years old affected by primary bone tumors of the spine, surgically treated with en bloc resection from 1996 to 2016. Clinical and radiological characteristics, therapy, complications and survival are reported.

Results

Only 12/22 cases had not been previously treated. 22.7% experienced at least one early complication; 18.2% and 4.1% experienced at least 2 and ≥ 3 early complications, respectively; 40.9% experienced at least one late complication, often related to hardware failure (27.3%); 18.2% and 4.5% at least 2 and ≥ 3 late complications. No early nor late complications were experienced in 12 out of 22 patients (54.54%). The overall survival and the local recurrence-free survival at 5 years were, respectively, 79.5% and 74.8%; considering only the patients with high-grade tumors, they were 70.9% and 65.5%, respectively. At 77.3 months of median follow-up, 17 patients are still alive, 16 of whom without any evidence of disease and 1 with evidence of local and systemic disease; four patients died with evidence of local disease and one with distant metastases but no local recurrence.

Conclusions

Young people with primary malignant or locally aggressive bone tumors of the spine should be treated in specialized centers, and wide surgery should be performed. The most frequent problems are related to reconstruction in a growing spine and subsequent hardware failure that make later surgeries necessary.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

---

受原发性脊柱肿瘤影响的16岁以下患者的整块切除：一系列22例患者的适应症，结果和并发症。

目的

回顾了22例因脊柱原发性骨肿瘤而接受整块切除的16岁以下的患者，并描述了临床表现，肿瘤特征，结果以及与手术治疗相关的并发症，强调了与手术相关的具体问题年轻的年龄。

方法

我们对1996年至2016年接受整块外科手术治疗的所有16岁以下受脊柱原发性骨肿瘤影响的患者进行了回顾。报道了临床和放射学特征，治疗，并发症和生存率。

结果

之前未曾治疗过仅12/22例病例。22.7％经历了至少一种早期并发症；18.2％和4.1％分别经历了至少2和≥3的早期并发症；40.9％的患者至少经历了一次晚期并发症，通常与硬件故障有关（27.3％）；至少2和≥3个晚期并发症的发生率为18.2％和4.5％。22例患者中有12例未发生早期或晚期并发症（54.54％）。5年总生存率和局部无复发生存率分别为79.5％和74.8％；仅考虑患有高度肿瘤的患者，它们分别为70.9％和65.5％。在77.3个月的中位随访中，有17名患者还活着，其中16名没有任何疾病的证据，1名有局部和全身性疾病的证据；

结论

患有原发性脊柱恶性或局部侵袭性骨肿瘤的年轻人应在专门的中心接受治疗，并应进行广泛的手术。最常见的问题与不断增长的脊柱重建以及随后的硬件故障有关，这使得以后的手术变得必要。

图形摘要

这些幻灯片可以在“电子补充材料”下找到。