Evidence map›Paper›PMID 38014475›Full record

ArticleOrthopaedic surgery2024

Surgical Strategy for Recurrent Giant Cell Tumor in the Thoracolumbar Spine.

Ao Leng, Minglei Yang, Haitao Sun, Zeyu Dai, Zhi Zhu, Wei Wan, Jianru Xiao

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Ao LengDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.ORCID https://orcid.org/0000-0001-9499-8286
Minglei YangDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Haitao SunDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Zeyu DaiDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Zhi ZhuDepartment of Pathology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Wei WanDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Jianru XiaoDepartment of Orthopedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Shanghai Changzheng Hospital · CNSecond Military Medical University · CN

Funding

National Key Research and Development Project of China 2016YFC0902100Science and Technology Commission of Shanghai Municipality 19411962700Science and Technology Commission of Shanghai Municipality 21MMC1930100the Logistics Support Department of PLA 21QNPY044
6 · The paper itself

Abstract

objectiveRecurrent giant cell tumor (RGCT) of the spine represents a clinical challenge for surgeons, and the treatment strategy remains controversial. This study aims to describe the long-term follow-up outcomes and compare the efficacy of en bloc spondylectomy versus piecemeal spondylectomy in treating RGCT of the thoracolumbar spine.

methodsA total of 32 patients with RGCT of the thoracolumbar spine treated from June 2012 to June 2019 were retrospectively reviewed. A total of 15 patients received total en bloc spondylectomy (TES) with wide or marginal margin while 17 patients received total piecemeal spondylectomy (TPS) with intralesional margin. Postoperative Eastern Cooperative Oncology Group Performance Score (ECOG-PS), Frankel classification and recurrence-free survival (RFS) were evaluated after surgery. Survival curves were estimated by the Kaplan-Meier method and differences were analyzed with the log-rank test. Multivariate analysis was performed with Cox regression to identify the independent prognostic factors affecting RFS.

resultsDuring a median follow-up of 41.9 ± 17.5 months, all patients with compromised neurologic functions exhibit significant improvement, with the mean ECOG-PS decreasing from 1.5 ± 1.3 to 0.13 ± 0.3 (p < 0.05). Among the 17 patients treated with TPS, eight patients developed local recurrence after a median time of 15.9 ± 6.4 months and four patients died from progressive disease. On the other hand, local recurrence were well managed with TES, since only one out of 15 patients experienced local relapse and all patients are alive with satisfied function at the latest follow-up. The median RFS for patients receiving TES and TPS are 75.0 months (95% CI: 67.5-82.5 m) and 38.3 months (95% CI: 27.3-49.3 m) respectively (p = 0.008). Multivariate analysis shows that the Ki67 index (p = 0.016), resection mode (p = 0.022), and denosumab (p = 0.039) are independent risk factors affecting RFS.

conclusionsTES with wide/marginal margin should be offered to patients with RGCT whenever feasible, given its long-term benefits in local control and symptom alleviation. Additionally, patients with lower Ki67 index and application of denosumab tend to have a better prognosis.

Indexed as

Giant Cell TumorsSpinal NeoplasmsDenosumabHumansKi-67 AntigenNeoplasm Recurrence, LocalRetrospective StudiesSpineTreatment OutcomeDenosumabKi-67 AntigenDenosumabEn bloc spondylectomyGiant cell tumor of boneSpinal neoplasms

Identifiers

PMID38014475
PMCPMC10782228
OpenAlexW4389091920

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.