European Spine Journal

, Volume 28, Issue 6, pp 1468–1479 | Cite as

Clinical significance of traditional clinical parameters and inflammatory biomarkers for the prognosis of patients with spinal chondrosarcoma: a retrospective study of 150 patients in a single center

  • Kehan Xu
  • Bo Li
  • Quan Huang
  • Dongjie Jiang
  • Haitao Sun
  • Nanzhe Zhong
  • Wei WanEmail author
  • Haifeng WeiEmail author
  • Jianru XiaoEmail author
Original Article



To investigate the clinical significance of five inflammatory biomarkers and conventional clinical parameters in prognostic prediction of spinal chondrosarcoma.


Univariate and multivariate analyses were performed to investigate independent prognostic factors for recurrence and death of patients with spinal chondrosarcoma. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan–Meier curve, and differences were analyzed by log-rank test. The optimal cutoff values for NLR, PLR, LMR, and CAR were determined by X-tile program.


The optimal cutoff value for NLR, PLR, LMR, AGR, and CAR was 2.7, 200, 3.0, 1.5, and 0.2, respectively. Of the 150 patients included, recurrence was detected in 105 patients, and death occurred in 78 patients. Multivariate analysis indicated that Tomita I–III, total resection, and CAR < 0.2 were significantly associated with longer DFS. Meanwhile, preoperative Frankel score D–E, total resection, and CAR < 0.2 were favorable prognostic factors for OS. Subtype analysis showed that only total resection was an independent prognostic factor for DFS of recurrent spinal chondrosarcoma.


Total resection could significantly reduce the recurrence rate of spinal chondrosarcoma and improve OS of chondrosarcoma patients. Tomita classification I–III was a favorable factor for DFS, and preoperative Frankel score A–C was an adverse prognostic factor for OS. CAR was the most robust prognostic indicator with a discriminatory ability as compared with other inflammatory indicators.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Spinal chondrosarcoma Inflammatory biomarkers Disease-free survival Overall survival Prognosis 



Disease-free survival


Overall survival


Neutrophil-to-lymphocyte ratio


Platelet-to-lymphocyte ratio


Lymphocyte-to-monocyte ratio


Albumin/globulin ratio


C-reactive protein-to-albumin ratio


Hazard ratio


Confidence interval


Authors’ contributions

JX offered the research direction regarding the prognostic role of preoperative D-dimer and inflammatory biomarkers in spinal ESFTs. WF and WW designed the study and gave us several meaningful suggestions. JL, HS, and NZ reviewed and collected the medical records. QH and BL analyzed and interpreted the patient data. KX was a contributor in writing the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

No conflict of interest exits in the submission of this manuscript, and manuscript is approved by all authors for publication. I would like to declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part.

Ethical approval

All procedures involving human participants performed in studies were approved by Changzheng Hospital Ethics Committee, and informed consents were obtained from all patients or their legal guardians.

Consent for publication

Patients or their legal guardians know and approve the publication.

Supplementary material

586_2019_5993_MOESM1_ESM.pptx (27.5 mb)
Supplementary file1 (PPTX 28153 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Oncology, Changzheng HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China

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