title: Giant cell tumor of the mobile spine: a review of 49 cases.
abstract: METHODS
  This is a retrospective review of 49 cases of giant cell tumor (GCT) of the mobile spine treated surgically.
  
  
  OBJECTIVE
  Our goal was to determine which factors influenced local recurrence.
  
  
  BACKGROUND
  GCT is a benign, locally aggressive tumor that rarely occurs in the spine. The management of local recurrence can be challenging.
  
  
  METHODS
  We performed a retrospective analysis of GCTs of the mobile spine managed between 1970 and 2005. Median follow-up was 145 months with a minimum of 2 years or until death. We used the Kaplan-Meier method to test whether Enneking stage, surgery type, and surgical margin had statistically significant impact on local recurrence. The log rank test was used for comparison, and a P value of less than 0.05 was deemed significant.
  
  
  RESULTS
  Of the 49 patients, 11 (22%) local recurrences occurred. The latest recurrence occurred at 60 months. Age less than 25 years was associated with a worse relapse-free survival (P = 0.03). En bloc resection was associated with better local control with Enneking stage III tumors (P = 0.01); however, intralesional resection provided adequate control of Enneking stage II tumors. There were 6 (12%) cases of metastasis, and 2 patients died from the progression of their disease. One patient died from the complications of the surgery.
  
  
  CONCLUSIONS
  En bloc resection should be considered for Enneking stage III GCTs of the mobile spine. The choice of en bloc resection must be balanced with the inherent risks of the procedure. Intralesional resection of Enneking stage II tumors provides adequate local control. Patients should be followed for at least 5 years because local relapse can occur late.
authors.affiliation: Department of Spine Oncology, Rizzoli Institute, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Boriani
authors.forename: Stefano
authors.initials: S
authors.lastname: Bandiera
authors.forename: Roberto
authors.initials: R
authors.lastname: Casadei
authors.forename: Luca
authors.initials: L
authors.lastname: Boriani
authors.forename: Rakesh
authors.initials: R
authors.lastname: Donthineni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Elettra
authors.initials: E
authors.lastname: Pignotti
authors.forename: Roberto
authors.initials: R
authors.lastname: Biagini
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Schwab
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult