scholarly journals Assessment of the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma based on pattern of post-surgical progression

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peng Wang ◽  
Haihua Zhou ◽  
Gaohua Han ◽  
Qingtao Ni ◽  
Shengbin Dai ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Gastric Adenocarcinoma ◽  
Adjuvant Radiotherapy ◽  
Cox Regression ◽  
Radical Resection ◽  
Progression Rate ◽  
Cox Regression Analysis ◽  
T Stage ◽  
Local Progression ◽  
Degree Of Differentiation

Abstract Purpose To assess the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma and to investigate subgroups of patients suitable for adjuvant radiotherapy. Methods and materials Data from 785 patients with gastric adenocarcinoma who had undergone D1/D2 radical resection and adjuvant chemotherapy were collected, the site of first progression was determined, and the relationship between the rate of local recurrence and clinicopathologic features was analyzed. Results By the end of the follow-up period, progression was observed in 405 patients. Local recurrence was observed as the first progression in 161 cases. The local recurrence rate was significantly lower than the non-local progression rate (20.5% vs 31.5%, p=0.007). Multivariate Cox regression analysis showed a significant relationship among degree of differentiation, T stage, N stage, and rate of local recurrence. Conclusions Not all patients with gastric carcinoma required adjuvant radiotherapy. However, patients with poorly differentiated cancer cells, advanced T stage (T3/T4), and positive lymph nodes, which included patients in the T4N1-2M0 subgroup, were recommended for adjuvant radiotherapy.

Inflammatory markers in cerebrospinal fluid: independent prognostic biomarkers in amyotrophic lateral sclerosis?

2019 ◽  
pp. jnnp-2018-319586 ◽  
Author(s):  
Benjamin Gille ◽  
Maxim De Schaepdryver ◽  
Lieselot Dedeene ◽  
Janne Goossens ◽  
Kristl G Claeys ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cerebrospinal Fluid ◽  
Disease Progression ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Progression Rate ◽  
Cox Regression Analysis ◽  
Lateral Sclerosis ◽  
Discriminatory Performance

ObjectiveInflammation is a key pathological hallmark in amyotrophic lateral sclerosis (ALS), which seems to be linked to the disease progression. It is not clear what the added diagnostic and prognostic value are of inflammatory markers in the cerebrospinal fluid (CSF) of patients with ALS.MethodsChitotriosidase-1 (CHIT1), chitinase-3-like protein 1 (YKL-40) and monocyte chemoattractant protein-1 (MCP-1) were measured in CSF and serum of patients with ALS (n=105), disease controls (n=102) and patients with a disease mimicking ALS (n=16). The discriminatory performance was evaluated by means of a receiver operating characteristic curve analysis. CSF and serum levels were correlated with several clinical parameters. A multivariate Cox regression analysis, including eight other established prognostic markers, was used to evaluate survival in ALS.ResultsIn CSF, CHIT1, YKL-40 and MCP-1 showed a weak discriminatory performance between ALS and ALS mimics (area under the curve: 0.79, p<0.0001; 0.72, p=0.001; 0.75, p=0.001, respectively). CHIT1 and YKL-40 correlated with the disease progression rate (ρ=0.28, p=0.009; ρ=0.34, p=0.002, respectively). CHIT1 levels were elevated in patients with a higher number of regions displaying motor neuron degeneration (one vs three regions: 4248 vs 13 518 pg/mL, p = 0.0075). In CSF, YKL-40 and MCP-1 were independently associated with survival (HR: 29.7, p=0.0003; 6.14, p=0.001, respectively).ConclusionsOur findings show that inflammation in patients with ALS reflects the disease progression as an independent predictor of survival. Our data encourage the use of inflammatory markers in patient stratification and as surrogate markers of therapy response in clinical trials.

scholarly journals 73. PREDICTION OF A SECOND LOCAL RECURRENCE IN SURGICALLY TREATED RECURRENT BRAIN METASTASES PATIENTS

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii15-ii15
Author(s):  
Ishaan Tewarie ◽  
Alexander Hulsbergen ◽  
Manish Paranjpe ◽  
Ray Jhun ◽  
Arun Job ◽  
...  
Keyword(s):  
Risk Factor ◽  
Local Recurrence ◽  
Tumor Volume ◽  
Cox Regression ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Common Occurrence ◽  
Total Resection ◽  
Cox Regression Analysis

Abstract BACKGROUND Local recurrence is a common occurrence after resection or radiotherapy for brain metastasis (BM). Very little is known about the benefit of (re-)craniotomy in this scenario: does resecting the initial local recurrence (LR1) invariably lead to a second local recurrence (LR2)? This study aimed to analyze occurrence and predictors of LR2 in BM patients undergoing craniotomy for LR1. METHODS Patients were identified from a departmental database at the Brigham and Women’s Hospital, Boston, MA. Multivariable logistic regression and cox regression analysis was performed to identify predictors of binary occurrence of LR2 (yes/no) and time-to-LR2, respectively. Based on predictors, subgroup-specific prevalence of LR2 was explored. RESULTS A total of 188 patients were identified. The median age was 59.5 years and 117 patients (62.2%) were female. Treatment-wise, 64 patients (34.0%) underwent subtotal resection (STR) and 66 (35.1%) received adjuvant radiation. Eighty-one (43.1%) patients experienced LR2 at a median of 7 months after craniotomy. Occurrence of LR2 was significantly associated with STR (OR 6.88, p = 0.0008), surgery as treatment for LR1 (OR = 0.26, p = 0.03), larger tumor volume (OR = 1.14 per 1000 mm3, p = 0.01), and frontal location (OR = 5.23, p = 0.02). Shorter time-to-LR2 was associated with STR (HR = 5.31, p = 0.01) and adjuvant radiation (HR = 2.22, p = 0.03), while temporal (HR = 0.16, p = 0.03) and parietal (0.13, p = 0.03) location were associated with longer time-to-LR2. When stratifying by extent of resection, prevalence of LR2 was 32.8% after gross total resection and 57.1% after STR. CONCLUSION In this population, LR2 occurred in 43.1% of patients. STR was the strongest risk factor for LR2, while tumor size, location, surgical treatment of LR1, and receipt of adjuvant radiation may also influence subsequent recurrence.

scholarly journals Increased RCAS1 Expression Is Associated with Advanced Histopathological Stage and Poor Prognosis in Patients with Gastric Adenocarcinoma

2013 ◽  
Vol 35 ◽  
pp. 213-219 ◽  
Author(s):  
Constantinos Giaginis ◽  
Themistoclis Efkarpidis ◽  
Paraskevi Alexandrou ◽  
Efstratios Patsouris ◽  
Gregory Kouraklis ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Cox Regression ◽  
Human Tumor ◽  
Clinicopathological Parameters ◽  
Rank Test ◽  
Survival Times ◽  
Biological Behaviour ◽  
Tissue Samples ◽  
Cox Regression Analysis ◽  
Expression Levels

Background. The receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a human tumor-associated antigen that has been considered to play a crucial role in tumor progression by enabling cancer cells to evade immune surveillance. The present study aimed to evaluate the clinical significance of the RCAS1 expression in gastric adenocarcinoma.Material and Methods. RCAS1 protein expression was assessed immunohistochemically on 54 gastric adenocarcinoma tissue samples and was analyzed in relation to clinicopathological parameters, tumor proliferative capacity, and patients’ survival.Results. Enhanced RCAS1 expression levels were significantly associated with advanced histopathological stage and presence of organ metastasis (P=0.0084andP=0.0327). Gastric cancer patients with elevated RCAS1 expression levels showed significantly shorter survival times compared to those with low RCAS1 expression (log-rank test,P=0.0168). In multivariate analysis, histopathological stage and grade of differentiation as well as the RCAS1 expression were identified as independent prognostic factors (Cox regression analysis,P=0.0204,P=0.0035, andP=0.0081).Conclusions. Our data support the evidence that RCAS1 upregulation may contribute to gastric malignant progression, representing a useful biomarker to predict the biological behaviour and prognosis in gastric neoplasia.

A prognostic nomogram for prediction of recurrence following surgical resection of desmoid tumors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10015-10015
Author(s):  
Aimee Marie Crago ◽  
Brian Denton ◽  
James J. Mezhir ◽  
Meera Hameed ◽  
Mithat Gonen ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Abdominal Wall ◽  
Cox Regression ◽  
Young Patients ◽  
Desmoid Tumors ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Prospective Database ◽  
Systemic Therapies

10015 Background: Desmoid tumors can respond to novel chemotherapeutics (e.g., sorafenib). We sought to construct a postoperative nomogram identifying desmoid patients who are at high-risk for local recurrence and potential candidates for systemic therapy. Methods: Desmoid patients undergoing resection from 1982-2011 were identified from a single-institution prospective database. Cox regression analysis was used to create a desmoid-specific recurrence nomogram integrating clinical risk factors. Results: Desmoids were treated surgically in 495 patients (median follow-up 60 months). Of 439 patients undergoing complete gross resection, 100 recurred (92 within 5 years of operation). Five-year recurrence-free survival (RFS) was 71%. Only 8 patients died of disease, all after R2 resection (6 with intraabdominal desmoids). Radiation was associated with worse RFS (p<0.001). Multivariate analysis suggested associations between recurrence and extremity location, young age, and large tumors, but not margin (Table). Abdominal wall tumors had the best outcome (5-year RFS 92% vs. 34% in patients <25y.o. with large, extremity tumors). Age, site and size were used to construct an internally-validated nomogram (concordance index 0.703). Integration of margin, gender, depth, and presentation status (primary vs. recurrent disease) did not improve concordance significantly (0.707). Conclusions: A postoperative nomogram including only size, site and age predicts local recurrence and aids in counseling patients. Systemic therapies may be tested in young patients with large, extremity desmoids, but surgery alone is curative for most abdominal wall lesions. [Table: see text]

Adjuvant chemotherapy following curative intent hepatectomy for intrahepatic cholangiocarcinoma: Results from a multi-institutional analysis of 575 patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4110-4110
Author(s):  
Dario Ribero ◽  
Antonio Daniele Pinna ◽  
Gennaro Nuzzo ◽  
Alfredo Guglielmi ◽  
Luca Aldrighetti ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Radical Resection ◽  
Continuous Variable ◽  
Outcome Data ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis

4110 Background: Surgical resection alone is the standard of care for patients with resectable intrahepatic cholangiocarcinoma (IHC). This study evaluates the benefit of adjuvant chemotherapy (AdjCTx) following curative intent hepatectomy for IHC. Methods: Clinicopathologic and long-term outcome data of 575 consecutive patients treated with curative intent hepatectomy for IHC (1995-2011) were extracted from a multi-institutional registry. After excluding operative mortality and M1 (n=46), Cox regression analysis was used to identify independent determinants of early recurrence (i.e., within 3 years). Propensity scores, which are used in observational studies to reduce selection bias by equating groups on the basis of relevant covariates, were calculated and utilized to match patients who had or had not AdjCTx (one-to-one match). Cases whose propensity score deviated more than 0.10 were considered unmatched and excluded from the analysis. Primary end-point was recurrence-free survival (RFS) at 3-years. Results: At a median FU of 42 months, 247 patients had recurred. Predictors of recurrence were LN metastases (HR 1.83 [1.36-2.44]), radical resection (HR 0.64 [0.45-0.9]), an elevated preoperative CA19.9 (HR 1.54 [1.15-2.07]), vascular invasion (HR 1.97 [1.49-2.61]), multiple tumors (HR 2.21 [1.71-2.86]), and size (analysed as continuous variable) (HR 1.01 [1.01-1.01]). After matching, no difference was observed between patients who had or had not AdjCTx (n=155 per group; 3-yrs RFS 28.3% vs. 38.0%, respectively; p=NS). When the analysis was restricted to patients who had gemcitabine, GEMOX or FOLFOX for 3 or more cycles (n=64 per group) again no difference emerged between patients who had or had not AdjCTx (3-yrs RFS 27.7% vs. 40.0% respectively, p=NS ). Conclusions: Our data suggest that AdjCTx following resection of IHC does not increase 3-years RFS.

Prediction of radiation therapy response in breast cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 565-565
Author(s):  
Divya Arora ◽  
Salman Hasan ◽  
Deborah Jebakumar ◽  
Yolanda Munoz ◽  
John Ford ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Cox Regression ◽  
Tumor Biology ◽  
Radiation Response ◽  
Cox Regression Analysis ◽  
Breast Cancer Radiotherapy ◽  
Unit Increase ◽  
Selection Of

565 Background: While radiation portals are tailored to a patient’s unique anatomy and the selection of systemic agents routinely employs biomarker data, the selection of radiotherapy based on a patient’s tumor biology is not routinely utilized in breast cancer. The purpose of this study was to identify which genetic markers are possible predictors for local recurrence as a surrogate for radiation response. Methods: We identified 200 patients who received radiotherapy for breast cancer. Selected tumor markers included: Androgen receptor (AR), Hypoxia Inducible Factor 1-α (HIF-1), Phosphotidylinosotol-4,5-bisphosphate 3-kinase (PI3K), and Interleukin 13 (IL-13). Biomarkers were analyzed in terms of “extent” and “intensity” on a scale of 0-3 and scored by 2 separate pathologists. The primary endpoint of local recurrence (LR) & secondary endpoint of overall survival were analyzed using Kaplan-Meier survival curves, log-rank test for differences, and Cox regression models. Results: Median follow up was 7.98 years. At 5 years, the rate of LR was 92.6% and overall survival was 89.4%. On multivariate Cox regression analysis, a one unit increase in IL-13 extent increased the hazard of LR by 73%. A one unit decrease in AR extent increased the hazard of LR by 134%. The hazard of death increased 3.2 times for each unit increase in HIF1 extent. The hazard of death increased 1.5 times for each unit increase in PI3K extent. PI3K extent and intensity was increased, and AR extent and intensity was decreased in triple negative breast cancer (TNBC) (n = 68) vs non-TNBC (p < 0.0001). African Americans had a 4.2 times hazard of LR vs Caucasians. Conclusions: Expression of IL-13 was associated with a higher risk of LR; expression of AR was associated with decreased LR. These two markers may be instrumental in predicting radiation response. If this study is validated, cancers that express more IL-13 may require higher doses or targeted therapy. In contrast, those cancers expressing AR may not require as aggressive therapy. Lastly, PI3K and HIF1 α expression were significant predictors of worse overall survival. The clinical implications of these biologic markers are significant as they may help to guide biologically-driven, personalized breast cancer radiotherapy.

scholarly journals Development and validation of a radiomics-based model to predict local progression-free survival after chemo-radiotherapy in patients with esophageal squamous cell cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
He-San Luo ◽  
Ying-Ying Chen ◽  
Wei-Zhen Huang ◽  
Sheng-Xi Wu ◽  
Shao-Fu Huang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Local Recurrence ◽  
Squamous Cell ◽  
Cox Regression ◽  
Validation Cohort ◽  
Cell Cancer ◽  
Clinical Factors ◽  
Free Survival ◽  
Training Cohort ◽  
Cox Regression Analysis

Abstract Purpose To develop a nomogram model for predicting local progress-free survival (LPFS) in esophageal squamous cell carcinoma (ESCC) patients treated with concurrent chemo-radiotherapy (CCRT). Methods We collected the clinical data of ESCC patients treated with CCRT in our hospital. Eligible patients were randomly divided into training cohort and validation cohort. The least absolute shrinkage and selection operator (LASSO) with COX regression was performed to select optimal radiomic features to calculate Rad-score for predicting LPFS in the training cohort. The univariate and multivariate analyses were performed to identify the predictive clinical factors for developing a nomogram model. The C-index was used to assess the performance of the predictive model and calibration curve was used to evaluate the accuracy. Results A total of 221 ESCC patients were included in our study, with 155 patients in training cohort and 66 patients in validation cohort. Seventeen radiomic features were selected by LASSO COX regression analysis to calculate Rad-score for predicting LPFS. The patients with a Rad-score ≥ 0.1411 had high risk of local recurrence, and those with a Rad-score < 0.1411 had low risk of local recurrence. Multivariate analysis showed that N stage, CR status and Rad-score were independent predictive factors for LPFS. A nomogram model was built based on the result of multivariate analysis. The C-index of the nomogram was 0.745 (95% CI 0.7700–0.790) in training cohort and 0.723(95% CI 0.654–0.791) in validation cohort. The 3-year LPFS rate predicted by the nomogram model was highly consistent with the actual 3-year LPFS rate both in the training cohort and the validation cohort. Conclusion We developed and validated a prediction model based on radiomic features and clinical factors, which can be used to predict LPFS of patients after CCRT. This model is conducive to identifying the patients with ESCC benefited more from CCRT.

scholarly journals HLA-G 3’UTR Polymorphisms Are Linked to Susceptibility and Survival in Spanish Gastric Adenocarcinoma Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Vaquero-Yuste ◽  
Ignacio Juarez ◽  
Marta Molina-Alejandre ◽  
Elisa María Molanes-López ◽  
Adrián López-Nares ◽  
...  
Keyword(s):  
Disease Progression ◽  
Gastric Adenocarcinoma ◽  
Somatic Mutations ◽  
Cox Regression ◽  
De Novo ◽  
Tnm Staging ◽  
Tissue Samples ◽  
Cox Regression Analysis ◽  
Adaptive Immune Cells ◽  
Significant Difference

HLA-G is a non-classical class I HLA molecule that induces tolerance by acting on receptors of both innate and adaptive immune cells. When overexpressed in tumors, limits surveillance by the immune system. The HLA-G gene shows several polymorphisms involved in mRNA and protein levels. We decided to study the implication of two polymorphisms (rs371194629; 14bp INS/DEL and rs1063320; +3142 C/G) in paired tissue samples (tumoral and non-tumoral) from 107 Spanish patients with gastric adenocarcinoma and 58 healthy control individuals, to assess the possible association of the HLA-G gene with gastric adenocarcinoma susceptibility, disease progression and survival. The presence of somatic mutations involving these polymorphisms was also analyzed. The frequency of the 14bp DEL allele was increased in patients (70.0%) compared to controls (57.0%, p=0.025). In addition, the haplotype formed by the combination of the 14bp DEL/+3142 C variants is also increased in patients (54.1% vs 44.4%, p=0.034, OR=1.74 CI95% 1.05-2.89). Kaplan-Meier analysis revealed that 14bp DEL/DEL patients showed lower 5-year life-expectancy than INS/DEL or INS/INS (p=0.041). Adjusting for TNM staging (Cox regression analysis) disclosed a significant difference in death risk (p=0.03) with an expected hazard 2.6 times higher. Finally, no somatic mutations were found when comparing these polymorphisms in tumoral vs non-tumoral tissues, which indicates that this is a preexisting condition in patients and not a de novo, tumor-restricted, event. In conclusion, the variants predominant in patients were those increasing HLA-G mRNA stability and HLA-G expression, clearly involving this molecule in gastric adenocarcinoma susceptibility, disease progression and survival and making it a potential target for immunotherapeutic approaches.

scholarly journals Development and Validation of Nomograms to Predict Prognosis of Oral and Oropharyngeal Mucoepidermoid Carcinoma: A SEER-Based Study

2020 ◽  
Author(s):  
muyuan liu ◽  
Litian Tong ◽  
Manbin Xu ◽  
Xiang Xu ◽  
Bin Liang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Mucoepidermoid Carcinoma ◽  
Cox Regression ◽  
Seer Database ◽  
Disease Specific Survival ◽  
Cox Regression Analysis ◽  
T Stage ◽  
N Stage ◽  
Disease Specific

Abstract Background: Due to the low incidence of mucoepidermoid carcinoma, there lacks sufficient studies for determining optimal treatment and predicting prognosis. The purpose of this study was to develop prognostic nomograms, to predict overall survival and disease-specific survival (DSS) of oral and oropharyngeal mucoepidermoid carcinoma patients, using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Methods: Clinicopathological and follow-up data of patients diagnosed with oral and oropharyngeal mucoepidermoid carcinoma between 2004 and 2017 were collected from the SEER database. The Kaplan-Meier method with the log-rank test was employed to identify single prognostic factors. Multivariate Cox regression was utilized to identify independent prognostic factors. C-index, area under the ROC curve (AUC) and calibration curves were used to assess performance of the prognostic nomograms. Results: A total of 1230 patients with oral and oropharyngeal mucoepidermoid carcinoma were enrolled in the present study. After multivariate Cox regression analysis, age, sex, tumor subsite, T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for overall survival. T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for disease-specific survival. Nomograms were constructed to predict the overall survival and disease-specific survival based on the independent prognostic factors. The fitted nomograms possessed excellent prediction accuracy, with a C-index of 0.899 for OS prediction and 0.893 for DSS prediction. Internal validation by computing the bootstrap calibration plots, using the validation set, indicated excellent performance by the nomograms. Conclusion: The prognostic nomograms developed, based on individual clinicopathological characteristics, in the present study, accurately predicted the overall survival and disease-specific survival of patients with oral and oropharyngeal mucoepidermoid carcinoma.

Factors Affecting Prognosis of Patients With Osteoblastoma of the Mobile Spine: A Long-Term Follow-up Study of 70 Patients in a Single Center

Neurosurgery ◽  
2018 ◽  
Vol 86 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Qi Jia ◽  
Chao Liu ◽  
Jian Yang ◽  
Huabin Yin ◽  
Jian Zhao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Local Recurrence ◽  
Cox Regression ◽  
En Bloc ◽  
Factors Affecting ◽  
Cox Regression Analysis ◽  
Initial Surgery ◽  
Mobile Spine ◽  
Enneking Stage ◽  
Aggressive Subtype

Abstract BACKGROUND Osteoblastoma (OBL) in the mobile spine is a benign tumor with aggressive potential. There is not much published information on OBL of the mobile spine as a result of rarity of the disease. There are controversies over the aggressive subtype and prognostic factors of the condition. OBJECTIVE To explore the aggressive subtype and investigate prognostic factors of OBLs in the mobile spine. METHODS A retrospective analysis of spinal OBL was performed by survival analysis. Patients in 2 cohorts were analyzed based on the Enneking grade and pathological evaluation. Local recurrence-free survival (RFS) was estimated using the Kaplan–Meier method to identify potential prognostic factors. Factors with P ≤ .05 were subjected to multivariate analysis by Cox regression analysis. P ≤ .05 were considered statistically significant. RESULTS Included in this study were 70 patients with spinal OBL who were followed up by a mean of 67.1 mo (range 24-188). Local recurrence was detected in 9 cases after initial surgery, and death occurred in 2 cases. The result of statistical analysis suggested that Epithelioid OBL (EO) with Enneking stage 3 (St.3) and total spondylectomy were independent prognostic factors for RFS. CONCLUSION St.3 or EO lesions seem to be more aggressive than St.2 or conventional osteoblastomas, but St.3 and EO should be considered simultaneously in predicting the aggressiveness of the lesion and the risk of recurrence. Total spondylectomy performed either by en bloc or piecemeal could significantly reduce recurrence of OBLs in the mobile spine.

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