INTRODUCTION: While surgical resection has been shown to improve short-term local disease control, it remains debated whether surgical resection is associated with improved overall survival in patients with malignant primary osseous spinal neoplasms. We reviewed survival data from a US cancer registry spanning 30 years to determine if surgical resection was independently associated with overall survival.

METHODS: The SEER registry (1973–2003) was queried to identify cases of histologically confirmed primary spinal chordoma, chondrosarcoma, osteosarcoma, or Ewing's sarcoma of the mobile spine and pelvis via ICD-O-2 coding. Patients with systemic metastasis were excluded. Age, sex, race, tumor location, and primary treatments were identified. Extent of local tumor invasion was classified as confined within periosteum vs extension beyond periosteum to surrounding tissues. The association of surgical resection with overall survival was assessed via Cox proportional-hazards regression analysis adjusting for age, radiotherapy, and tumor...

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