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脊柱转移癌局部复发再手术治疗 被引量:5

Reoperation treatment for recurrence spinal metastatic tumors
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摘要 目的探讨脊柱转移癌局部复发伴脊髓及/或神经根压迫患者再手术治疗适应证的选择及其临床效果。方法对19例局部复发的脊柱转移癌患者行再手术治疗(局部肿瘤彻底切除或肿瘤大部切除环形减压),患者术后定期随访,对患者神经功能水平进行评价,并通过MRI,CT及X线片等评估肿瘤局部复发情况。分析患者局部复发原因、手术适应证及预后。结果 16例患者行局部肿瘤彻底切除,平均手术时间142 min,术中平均出血量1 447 m L;3例患者行肿瘤大部切除环形减压,平均手术时间107 min,术中平均出血量783 m L。术后所有患者平均随访34.7个月,术后神经功能较术前均有不同程度改善,术后生活质量明显提高。患者局部复发主要由于初次手术未能彻底切除病灶及缺乏有效的辅助治疗措施。结论对于脊柱转移癌局部复发伴脊髓及/或神经根再次压迫的患者,在全身状况较好的情况下,仍可考虑再次手术并结合多学科综合治疗,控制肿瘤局部复发,挽救神经功能,提高患者生存质量,甚至延长生存期,但对于手术适应证需严格把握。 Objectives To investigate the indication of reoperation treatment for recurrence spinal metastatic tumors with spinal cord and/or nerve root compression, and to evaluate the clinical effect. Methods Surgical treatments ( Radical resection of tumors or circumferencial decompression) and follow-up were performed on 19 patients with recurrence spinal metastatic tumors. MRI, CT and roentgenograph were used to evaluate the local controal, and Frankel classification was used to evaluate the neurolocigal outcome. Recurrence reasons, surgical indications and prognosis were also analyzed. Results Sixteen patients underwent radical tumor resection with a mean time of 142 min, the mean blood loss was 1 447 mL, and 3 patients underwent circumfereneial decompression with a mean time of 107 rain and a mean blood loss of 783 mL. The mean time of follow-up was 34.7 months. Most patients' nurological status and quality of lives were conspicuously upgraded. Reasons of tumor local recurrence were insufficient primary surgery and lack of effective adjuvant therapies. Conclusions Surgery and effective adjuvant therapies with restricted indications, which could control tumor growth, save neurological functions, upgraded quality of life or even prolong the life expectancy, could be considered as effective measures for patients who suffered recurrence metastatic spinal lesions with moderate general conditions.
出处 《脊柱外科杂志》 2015年第3期153-157,共5页 Journal of Spinal Surgery
关键词 脊柱 肿瘤转移 肿瘤复发 局部 再手术 Spine Neoplasm Metastasis Neoplasm Recurrence, Local Reoperation
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参考文献16

  • 1Jacobs WB, Perrin RG. Evaluation and treatment of spinal metas- tases : an overview [ J ]. Neurosurg Focus, 2001, 11 (6) : e10.
  • 2Lee BH, Kim TH, Chong HS, et al. Prognostic factor analysis inpatients with metastatic spine disease depending on surgery and conservative treatment: review of 577 cases[ J ]. Ann Surg Oncol, 2013, 20(1) : 40-46.
  • 3Lee BH, Park JO, Kim HS, et al. Perioperative complication and surgical outcome in patients with spine metastases: retrospective 200-case series in a single institute [ J ]. Clin Neurol Neurosurg, 2014, 122: 80-86.
  • 4肖建如,贾连顺.脊柱转移性肿瘤的外科治疗策略[J].中华骨科杂志,2003,23(1):14-18. 被引量:29
  • 5陈铿,黄霖,蔡兆鹏,王鹏,叶记超,高梁斌,唐勇,沈慧勇.后路一期全脊椎切除术治疗复发性脊柱肿瘤[J].中华外科杂志,2015,53(2):121-125. 被引量:7
  • 6Cloyd JM, Acosta FL Jr, Polley MY, et al. En bloc resection for primary and metastatic tumors of the spine : a systematic review of the literature[ J]. Neurosurgery, 2010, 67 (2) : 435-444.
  • 7Gruber JJ, Colevas AD. Differentiated thyroid cancer: focus on emerging treatments for radioactive iodine-refractory patients [ J ]. Oncologist, 2015, 20(2) : 113-126.
  • 8Hecht JR, Reid TR, Garrett CR, et al. Phase I study of everoli- mus, cetuximab and irinotecan as second-line therapy in metastatic colorectal cancer [ J ]. Anticancer Res, 2015, 35 ( 3 ) : 1567-1573.
  • 9Tan X, Liu Y, Hou J, et al. Targeted therapies for renal cell car- cinoma in Chinese patients: focus on everolimus[ J]. Onco Tar- gets Ther, 2015, 8: 313-321.
  • 10Laufer I, Sciubba DM, Madera M, et al. Surgical management of metastatic spinal tumors [ J ]. Cancer Control, 2012, 19 (2) : 122-128.

二级参考文献21

  • 1肖建如,魏海峰,杨兴海,陈华江,王长峰,马俊明,杨诚,袁文,贾连顺.全脊椎切除治疗原发性、侵袭性和恶性腰椎肿瘤30例报告[J].中国骨肿瘤骨病,2006,5(3):129-132. 被引量:11
  • 2Roodman GD. Mechanisms of bone metastasis [ J ]. N Engl J Med, 2004,350 (16) : 1655-1664.
  • 3Sundaresan N, Rothman A, Manhart K, et al. Surgery for solitary metastases of the spine: rationale and results of treatment [J]. Spine (Phila Pa 1976),2002,27 (16) :1802-1806.
  • 4Tumita K, Kawahara N, Baba H, el al. Total en bloc spondylectomy for solitary spinal metastases[ J ]. Int Orthop, 1994-, 18 ( 5 ) :291-298.
  • 5Tomita K, Kawahara N, Baba H, et al. Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors [ J ]. Spine ( Phila Pa 1976 ) , 1997,22 ( 3 ) : 324- 333.
  • 6Tomita K, Kawahara N, Murakami H, et al. Total en bloc spondylectomy for spinal tumors : improvement of the technique and its associated basic background [ J ]. J Orthop Sci,2006,11 ( 1 ) : 3-12.
  • 7Yamazaki T, MeLoughlin GS, Patel S, et al. Feasibility and safety of en bloc resection for primary spine tumors : a systematic review by the Spine Oncology Study Group [ J ]. Spine (Phila Pa 1976 ) , 2009,34 (22 Suppl) : $31 -$38.
  • 8Amendola L, Cappuccio M, De lure F, et al. En bloc resections for primary spinal tumors in a 20 years of experience : effectiveness and safety [ J 1. Spine J, 2014, pii : S1529 -9430 ( 14 ) 00227-7.
  • 9Maynard FM Jr, Bracken MB, Creasey G, et al. International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association [ J ]. Spinal Cord,1997,35 ( 5 ) :266-274.
  • 10Huang L, Chen K, Ye JC, et al. Modified total en bloc spondylectomy for thoracolumbar spinal tumors via a single posterior approach [ J]. Eur Spine J,2013,22 (3) :556-564.

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