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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

This work was supported by the Shanghai Science Foundation of China (12DZ2295103) and National Natural Science Foundation of China (Grants 81402222, 81402223).

Conflict of interest

The authors declare that they have no conflict of interest.

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Author notes

    Authors and Affiliations

    1. Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Huabin Yin, Xinghai Yang, Wei Xu, Bo Li, Ting Wang, Tong Meng, Tielong Liu, Wang Zhou & Jianru Xiao

    2. Department of Pathology, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Binbin Li

    3. Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, China

      Peng Wang

    4. Department of Orthopedics, 149 Hospital, Lianyungang, Jiangsu, China

      Huabin Yin

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    1. Huabin Yin
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    2. Xinghai Yang
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    3. Wei Xu
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    Correspondence to Tielong Liu, Wang Zhou or Jianru Xiao.

    Additional information

    H. Yin, X. Yang, and W. Xu contributed equally to this work, and all should be considered first authors.

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    Yin, H., Yang, X., Xu, W. et al. Treatment and outcome of primary aggressive giant cell tumor in the spine. Eur Spine J 24, 1747–1753 (2015). https://doi.org/10.1007/s00586-015-3777-5

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    • DOI: https://doi.org/10.1007/s00586-015-3777-5

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