Suchergebnisse

Jian Yang,1,* Jijie Yan,2,* Meihui Zeng,3,* Wei Wan,1 Tielong Liu,1 Jian-Ru Xiao1 1Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China; 2Ningbo University, Ningbo, Zhejiang, People's Republic of China; 3Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China*These authors contributed equally to this workCorrespondence: Tielong Liu; Jian-Ru Xiao Tel +8602181885634Fax +8602163720099Email hahameixinmeifei@163.com; jianruxiao82@163.comBackground: With the occurrence and improvement of immunohistochemistry and other pathological diagnostic techniques, gastrointestinal stromal tumor (GIST) has been gradually recognized. With the prolonged survival of patients with GISTs, reports about the bone metastasis of GIST increased. However, the knowledge of GISTs is rather limited due to its very low incidence.Methods: Cochrane and Medline database (via PubMed) were searched in July 2019 with related keywords to acquire the literature related to the bone metastasis of GIST. Then, the literature was reviewed and references were also scanned to identify the possible related reports. Study data comprising age, sex, primary location, metastasis interval time, immunohistochemistry index, management and prognosis were recorded and analyzed.Results: Forty-five patients with bone metastases of GIST, with a mean age of 61.09 years, were included. The small intestine and stomach were the most common primary sites, followed by the rectum. Patients with small intestine primary sites had bone metastases that occurred earlier than the bone metastases stomach and rectum primary sites. The spine was the most common site of bony metastases. The mean survival time after GIST diagnosis was more than 64.02 months. Patients younger than 60 years old had a worse prognosis than those older than 60 years old. Furthermore, patients with spinal involvement had a worse prognosis than those without spinal involvement. Surgical interventions combined with targeted therapies guaranteed a better prognosis.Conclusion: Bone metastasis of GIST, which mainly occurs in the spine, is rather rare. Patients with GISTs of the small intestine and stomach suffered from bone metastasis more frequently and earlier than patients with GISTs in other primary sites. Age, sex, primary tumor location, treatment mode for the primary lesions and metastases, and spine involvement may be potential factors that affect the prognosis of GIST patients with bone metastases.Keywords: gastrointestinal stromal tumor, bone metastasis, tyrosine kinase inhibitors, prognosis

Wei-Dong Bao,1,* Qi Jia,2,* Tao Wang,2,3,* Yan Lou,2 Dong-Jie Jiang,2 Cheng Yang,2 Xinghai Yang,2 Quan Huang,2 Hai-Feng Wei,2 Jian-Ru Xiao1,2 1Department of Orthopedics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People's Republic of China; 2Department of Orthopedic Oncology, Spinal Tumor Center, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China; 3Department of Orthopeadics, Second Affiliated Hospital of Anhui Medical University, Hefei, 230000, People's Republic of China*These authors contributed equally to this workCorrespondence: Hai-Feng Wei; Jian-Ru XiaoDepartment of Orthopedic Oncology, Spine Tumor Center, Changzheng Hospital, Second Military Medical University, #415 Fengyang Road, Shanghai, 200003, People's Republic of ChinaTel +86-21-81886843Email gkxjl999@163.com; spine925@126.comPurpose: To investigate risk factors for instrumentation failure (IF) in titanium (Ti) mesh reconstruction for thoracic and lumbar tumors.Patients and Methods: The clinical data of patients with thoracic or lumbar tumors who received Ti mesh reconstruction via the posterior approach in our hospital from 2013 to 2018 were analyzed retrospectively. The observation indexes included sex, age, BMI, the vertebra resection mode, the number of resected vertebral segments, application of bone cement, radiotherapy, chemotherapy, revision or primary surgery, and primary tumor metastasis. Correlations between these factors and IF were analyzed by Kaplan–Meier survival and logistics regression analyses.Results: The 178 patients included 108 males and 70 females with a mean age of 48.09± 16.21 (6– 78) years and a mean follow-up period of 51.18 (24– 90) months. The data showed that 17 patients (9.55%) were inflicted with IF, involving the thoracic vertebra in 11 cases, thoracolumbar vertebrae (T12–L1) in 2 cases, and lumbar vertebrae in 4 cases. The mean interval between surgery to IF was 35.18± 14.17 (14– 59) months. Univariate analysis showed that total vertebral body resection, the number of resected vertebral segments, radiotherapy and multiple tumor resection were potential factors for IF, while multivariate analysis showed that only total vertebral body resection, the number of resected vertebral segments and radiotherapy were independent factors.Conclusion: Total vertebra resection, the number of resected vertebral segments (≥ 2) and radiotherapy before and after operation were significant risk factors related to IF.Keywords: instrumentation failure, titanium mesh, thoracic and lumbar tumors