Albendazole Therapy in Postoperative Spinal Cystic Echinococcosis: Evaluating Recurrence and Survival Outcomes Between Short and Long-Term Protocols

Introduction: The spine is a rare location in cystic echinococcosis even in endemic regions. Surgery is the treatment of choice. There are still uncertainties regarding anthelminthic treatment protocol and duration. Aim: To evaluate the impact of Albendazole therapy duration on the functional outcome, overall survival and recurrence-free survival in patients operated for spinal cystic echinococcosis (SCE) Methods: We retrospectively selected patients operated for SCE and collected their epidemiological, clinical, imaging, surgical, and outcomes data. These patients were categorized into two groups: a 6-month Albendazole therapy after surgery group and an indefinite treatment group. Statistical tests were applied to compare the outcomes. Results: Thirty-two patients were included, predominantly male (68%) with a mean age of 40 years. The thoracic level was involved in 56%, lumbar in 31% and cervical in 13% of cases. According to Dew/Braithwaite and Lees, 69% of our patients had dumbbell formation, 22% had type 2 and 9% had type 4 lesions. Complete resection was achieved in 50% of cases.18 patients received a 6-month Albendazole therapy while 14 patients received an indefinite treatment. All patients had a recurrence in a mean delay of 17.7 months. The only statistical difference between the two groups was the recurrence-free survival with a mean of 11.4 months for 6-month therapy patients and 27 months for long-term therapy patients (p=0.047). Conclusion: Post-operative SCE Albendazole treatment duration might not affect neither the functional outcome nor the overall survival. Otherwise, our findings suggest indefinite Albendazole therapy following SCE surgery could not prevent local recurrence but might delay it compared with 6-month therapy.