• Kehan Xu, Wei Wan, Bo Li, Jialin Li, Quan Huang, Yujie Liu, Dongjie Jiang, Yuduo Xu, and Jianru Xiao.
• Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Huangpu District, Shanghai, P.R. China.
• World Neurosurg. 2019 Feb 1; 122: e872-e880.

BackgroundGiant cell tumor (GCT) of the spine is a benign tumor with local aggressiveness and potential for recurrence. No published study has discussed the prognostic role of preoperative D-dimer (D-D) level in spinal GCT. The purpose of this retrospective study was to evaluate the prognostic value of preoperative plasma D-D level and clinical factors.MethodsRoutine clinical parameters and plasma D-D level were analyzed preoperatively. The disease-free survival (DFS) rate was estimated using Kaplan-Meier analysis. Variables with P value <0.1 were subjected to multivariate analysis by Cox regression analysis. P values <0.05 were considered statistically significant.ResultsThe recurrence rate of spinal GCT was 21.6% in our series. A total of 153 patients were stratified into 2 groups by preoperative D-D level of ≤0.5 μg/mL or >0.5 μg/mL. We found that several clinicopathologic features were associated with the D-D level, including tumor location, the segment involved, Jaffe grade, and recurrence (P < 0.05). Multivariate analysis indicated that the treatment history, resection mode, bisphosphonate treatment, and preoperative D-D level were prognostic factors of DFS (all P < 0.05). In addition, the Jaffe grading system stratified by preoperative plasma D-D level was correlated with DFS of patients with spinal GCT (P < 0.05).ConclusionsOur study demonstrated that preoperative plasma D-D level, total spondylectomy, bisphosphonate treatment, and treatment history were powerful independent prognostic factors for DFS of patients with spinal GCT, suggesting that preoperative plasma D-D level may be a useful biomarker for predicting recurrence and prognosis of spinal GCT.Copyright © 2018. Published by Elsevier Inc.

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