title: Osteosarcoma of the spine: surgical treatment and outcomes.
abstract: BACKGROUND
  The goal of this study was to determine whether there are correlations between various options of surgical treatment and long-term outcome for spinal osteosarcoma.
  
  
  METHODS
  This was a retrospective review of 16 patients with spinal osteosarcoma, who underwent surgical treatment from 1999 to 2010. Seven patients were given total en bloc spondylectomy (TES), while nine received piecemeal resection (there were seven cases of total piecemeal spondylectomy, one of sagittal resection, and one of vertebrectomy). The outcome and prognosis of the patients were evaluated, grouped by surgical treatment.
  
  
  RESULTS
  All 16 cases were followed for an average of 42.4 months. At follow-up, all patients noted that pain had eased or had gradually disappeared. Three months after surgery, eight patients (50.0%) had improved 1 to 2 grades in their neurological status, based on Frankel scoring. Six (37.5%) patients experienced local recurrence of the tumor, nine (56.3%) had metastases, and five (31.3%) died of the disease. Of the six patients who received a wide or marginal en bloc resection, none developed local recurrence or died from the disease. Conversely, of the ten patients who received intralesional or contaminated resections, six (60%) relapsed and five (50%) died from the disease.
  
  
  CONCLUSIONS
  TES, with a wide margin, should be planned for patients with osteosarcoma of the cervical and thoracolumbar spine, whenever possible. When the patients are not candidates for en bloc resection, total piecemeal spondylectomy is an appropriate choice for osteosarcoma in the mobile spine.
authors.affiliation: Spine Center, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Feng
authors.forename: Xinghai
authors.initials: X
authors.lastname: Yang
authors.forename: Tielong
authors.initials: T
authors.lastname: Liu
authors.forename: Jianru
authors.initials: J
authors.lastname: Xiao
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Wu
authors.forename: Quan
authors.initials: Q
authors.lastname: Huang
authors.forename: Junming
authors.initials: J
authors.lastname: Ma
authors.forename: Wending
authors.initials: W
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Cui
authors.forename: Huazi
authors.initials: H
authors.lastname: Xu
authors.forename: Yong
authors.initials: Y
authors.lastname: Teng
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult