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Oxford spinal sarcoma service: excellent oncological outcomes with a centralised multidisciplinary approach to primary spinal tumour care

Abstract:
Purpose
The Oxford Spinal Sarcoma Service is a designated primary spinal tumour referral centre in the United Kingdom serving over ten million residents. We report the outcomes of this centralised approach to primary spinal tumour care.

Methods
This is a retrospective review of surgically treated primary spinal tumour patients during 2008-2022. Patients were classified based on tumour resection margins - Enneking Appropriate (EA) or Enneking Inappropriate (EI). Outcomes studied include local recurrence and overall survival.

Results
119 patients were included. 86/119(72%) cases involved the mobile spine; 33/119(28%), the sacrum. 96/119(81%) patients were virgin cases. EA margins were achieved in 68%(81/119) of cases. There were 38/119(32%) EI patients; 23/38(61%) were non-virgin cases which precluded EA resection. EA resection was achieved 90%(81/90) of the time when attempted. In EA patients with mobile spine tumours, local recurrence rate was 2%(1/51), vs. 18%(5/28) in EA patients with sacral tumours, 20%(7/35) in EI patients with mobile spine tumours, and 80%(4/5) in EI patients with sacral tumours. Mean local recurrence-free survival was 5.2(range 1-13.5) years; local recurrence rate, 18.5%(22/119). Mortality rate was 21.0%(25/119); mean overall survival was 5.63(range 1-13.5) years post-surgery. On multivariate analysis, EI margins and post-operative systemic treatment were significant predictors for local recurrence; presence of metastases and pre-operative systemic therapy, significant predictors for mortality.

Conclusion
Centralisation of primary spinal tumour care has led to excellent oncological results comparable to most large spinal tumour centres. In mobile spine primary tumours where EA margins were achieved, our local recurrence rate (2.0%) is one of the lowest reported in literature.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s00586-025-08893-y

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Oxford college:
Pembroke College
Role:
Author
ORCID:
0000-0002-4595-6482


Publisher:
Springer
Journal:
European Spine Journal More from this journal
Volume:
34
Issue:
8
Pages:
3592–3600
Publication date:
2025-05-31
Acceptance date:
2025-04-25
DOI:
EISSN:
1432-0932
ISSN:
0940-6719


Language:
English
Keywords:
Pubs id:
2127425
Local pid:
pubs:2127425
Deposit date:
2025-06-01
ARK identifier:

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