脊柱神经鞘瘤术后无病生存期的风险因素分析

Risk factors for disease-free survival after spinal neurilemmoma surgery

目的探讨脊柱神经鞘瘤的临床治疗方式,并讨论影响手术预后的风险因素。方法回顾性分析本科自2016年1月-2017年9月行手术治疗的50例脊柱神经鞘瘤患者临床资料,随访观察其无病生存期,采用单因素及多因素分析探讨其术后无病生存期的影响因素,并采用生存曲线揭示相关因素对患者无病生存期的影响。结果50例随访中,14例患者复发。患者平均无病生存时间为26.4个月(3~44个月,中位时间24个月)。单因素及多因素分析发现,术前Frankel分级和术后病理结果是其独立危险因素(P<0.05)。结论术前Frankel分级是影响脊柱神经鞘瘤患者肿瘤复发的独立危险因素;与良性脊柱神经鞘瘤相比,恶性脊柱神经鞘瘤患者术后复发率更高,预后更差。

Objective To investigate the clinical treatment of spinal neurilemmoma and discuss the risk factors affecting the surgical prognosis.Methods The clinical data of 50 patients with spinal neurilemmoma who underwent surgical treatment from January 2016 to September 2017 were retrospectively analyzed.The disease-free survival time was observed.The influencing factors of disease-free survival were analyzed by univariate and multivariate analysis,and the influence of related factors on disease-free survival was revealed by survival curve.Results During the follow-up of 50 cases,14 cases recurred.The mean disease-free survival time was 26.4 months(3-44 months,median 24 months).Univariate and multivariate analysis showed that preoperative Frankel score and postoperative pathological results were independent risk factors(P<0.05).Conclusion Preoperative Frankel score is an independent risk factor for tumor recurrence in patients with spinal neurilemmoma.Compared with benign spinal schwannoma,patients with malignant spinal neurilemmoma have higher recurrence rate and worse prognosis.