Clinical significance of traditional clinical parameters and inflammatory biomarkers for the prognosis of patients with spinal chondrosarcoma: a retrospective study of 150 patients in a single center

Eur Spine J. 2019 Jun;28(6):1468-1479. doi: 10.1007/s00586-019-05993-4. Epub 2019 May 4.

Abstract

Background: To investigate the clinical significance of five inflammatory biomarkers and conventional clinical parameters in prognostic prediction of spinal chondrosarcoma.

Methods: Univariate and multivariate analyses were performed to investigate independent prognostic factors for recurrence and death of patients with spinal chondrosarcoma. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier curve, and differences were analyzed by log-rank test. The optimal cutoff values for NLR, PLR, LMR, and CAR were determined by X-tile program.

Results: The optimal cutoff value for NLR, PLR, LMR, AGR, and CAR was 2.7, 200, 3.0, 1.5, and 0.2, respectively. Of the 150 patients included, recurrence was detected in 105 patients, and death occurred in 78 patients. Multivariate analysis indicated that Tomita I-III, total resection, and CAR < 0.2 were significantly associated with longer DFS. Meanwhile, preoperative Frankel score D-E, total resection, and CAR < 0.2 were favorable prognostic factors for OS. Subtype analysis showed that only total resection was an independent prognostic factor for DFS of recurrent spinal chondrosarcoma.

Conclusion: Total resection could significantly reduce the recurrence rate of spinal chondrosarcoma and improve OS of chondrosarcoma patients. Tomita classification I-III was a favorable factor for DFS, and preoperative Frankel score A-C was an adverse prognostic factor for OS. CAR was the most robust prognostic indicator with a discriminatory ability as compared with other inflammatory indicators. These slides can be retrieved under Electronic Supplementary Material.

Keywords: Disease-free survival; Inflammatory biomarkers; Overall survival; Prognosis; Spinal chondrosarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cell Count
  • Child
  • China / epidemiology
  • Chondrosarcoma / blood
  • Chondrosarcoma / mortality*
  • Chondrosarcoma / surgery*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Monocytes / metabolism
  • Neoplasm Recurrence, Local
  • Neutrophils / metabolism
  • Platelet Count
  • Prognosis
  • Retrospective Studies
  • Serum Albumin
  • Serum Globulins
  • Spinal Neoplasms / blood
  • Spinal Neoplasms / mortality*
  • Spinal Neoplasms / surgery*
  • Young Adult

Substances

  • Biomarkers
  • Serum Albumin
  • Serum Globulins
  • C-Reactive Protein