• Chao Tang, Dongdong Wang, Yuman Wu, Hengyuan Xu, and Hailong Zhang.
• Orthopedic Department, People's Hospital of Putuo District, Tongji University School of Medicine, Shanghai, China; Pain Department, Pizhou City People's Hospital, Xuzhou Medical University, Xuzhou City, China.
• World Neurosurg. 2022 Aug 1; 164: e367-e386.

ObjectiveThe treatment of osteosarcoma of the spine remains controversial. Our aim was to explore the treatment of patients with spinal osteosarcoma.MethodsWe analyzed the data from 727 spinal osteosarcoma patients from the Surveillance, Epidemiology, and End Results database from 1973 to 2015. X-tile software was used to find the optimal cutoff values for age and economic income. The Kaplan-Meier estimator method was used to analyze overall survival and cancer-specific survival. Univariate and multivariate Cox analyses were used to identify the independent prognostic factors. Propensity score matching was used to reduce the possibility of selection bias. A logistic regression model was used to clarify the relevant factors affecting a patient's decision to undergo surgery.ResultsAmong 727 eligible spinal osteosarcoma patients, 370 (50.9%) had undergone surgery and 357 (49.1%) had not undergone surgery. Significant differences were found in the effects of patient age at diagnosis, Surveillance, Epidemiology, and End Results historical stage, and tumor grade on the patients' decision to undergo surgery (P < 0.05). Surgery was an independent prognostic factor for overall survival and cancer-specific survival of patients with spinal osteosarcoma. The same results were found after 1:1 propensity score matching. The surgery group had more favorable survival compared with the nonsurgery group.ConclusionsSurgery can provide survival benefits for patients with osteosarcoma of the spine. The patients with spinal osteosarcoma who had undergone surgery experienced favorable survival benefits. Thus, surgery can be a suitable treatment for patients with spinal osteosarcoma.Copyright © 2022 Elsevier Inc. All rights reserved.

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