Primary High-Grade Spinal Sarcomas: A Retrospective Review of 10 Cases

Introduction: Aggressive surgical resection with adequate margins is associated with improved local control and survival in selected patients with primary spinal sarcomas. However, anatomical constraints often preclude complete resection, and outcomes for unresectable tumors remain poor. This retrospective cohort study aimed to compare oncological and functional outcomes between patients with primary spinal sarcomas who underwent surgical resection with reconstruction and those who were managed without resection. Methods: Ten patients with primary spinal sarcomas treated between 2010 and 2020 were retrospectively reviewed. Six patients underwent surgical resection with spinal reconstruction (R group), and four were treated without resection (N group). The mean age was 51.8 years (range, 15-71 years) in the R group and 73.0 years (range, 53-91 years) in the N group. Clinical variables, recurrence, metastasis, overall survival (OS), and activities of daily living (ADL), including ambulatory status, were evaluated. OS was analyzed using the Kaplan-Meier method and compared using the log-rank test. Results: Tumor size at initial presentation was comparable between the groups (48.3 mm (range, 24 mm-68 mm) in the R group and 48.8 mm (range, 38mm-75 mm) in the N group). Metastases occurred in three patients (50%) in the R group and three patients (75%) in the N group. Two patients (33%) in the R group remained disease-free, whereas all patients in the N group died during follow-up. The five-year OS rate was 60% in the R group and 0% in the N group, with no significant difference (p=0.23). Ambulatory function was preserved in five patients (83%) in the R group and one patient (25%) in the N group. Conclusions: Although a definitive survival benefit could not be demonstrated, surgical resection with reconstruction was associated with superior postoperative functional outcomes, suggesting a role in preserving ambulation and quality of life in patients with primary spinal sarcomas.