STUDY DESIGN: Retrospective cohort (case only). OBJECTIVE: To evaluate the results and survival determinants of 21 patients with sacral chordomas treated with en bloc resection and adjuvant radiotherapy. SUMMARY OF BACKGROUND DATA: There are few long-term studies on treatment of sacral chordomas with more than 20 patients, and factors related to survival are not fully understood. METHODS: Demographics, treatment, complications, and oncological outcomes were analyzed with summary statistics, hypothesis testing with Mantel-Haenszel-Cox analysis, log-rank test, Cox proportional hazard model, and Kaplan-Meier survival estimates as applicable. RESULTS: There were 12 males and 9 females with mean age of 61 years (16-79) and mean follow-up of 5.8 years (2-19.2). Tumor stage was IB in 20 and IIIB in one; mean tumor size was 10.5 cm. Fourteen patients underwent combined anterior-posterior resection and 7 posterior resection alone; 18 received adjuvant radiotherapy. After treatment, bowel and bladder control were present in 4 and 5 patients, respectively. Complications included: wound infection (4), other wound complications (9), fistula (2), deep vein thrombosis (1), and pulmonary embolism (1). Median survival was 7.2 years. Eight (40%) had local recurrence and 4 (19%) metastatic disease. Mean disease-free interval before recurrence was 2.5 years (1-5). No patient (n = 8) treated in the past 9 years has had local or distant disease. Patients treated for recurrent tumor survived 5.7 years on average (range, 0.8-9) after the first recurrence. The only risk factor for tumor recurrence was proximal tumor extent (P = 0.05) There was a statistically significant association between recurrence and survival (RR = 3.8; 95% confidence interval, 1.0-15.3; P = 0.04). CONCLUSION: Despite the complications, increased long-term survival can be achieved with treatment. Proximal tumor extent may be related to recurrence and survival. Recurrence rates have diminished over time, emphasizing the importance of an experienced multidisciplinary surgical team. LEVEL OF EVIDENCE: N/A.
STUDY DESIGN: Retrospective cohort (case only). OBJECTIVE: To evaluate the results and survival determinants of 21 patients with sacral chordomas treated with en bloc resection and adjuvant radiotherapy. SUMMARY OF BACKGROUND DATA: There are few long-term studies on treatment of sacral chordomas with more than 20 patients, and factors related to survival are not fully understood. METHODS: Demographics, treatment, complications, and oncological outcomes were analyzed with summary statistics, hypothesis testing with Mantel-Haenszel-Cox analysis, log-rank test, Cox proportional hazard model, and Kaplan-Meier survival estimates as applicable. RESULTS: There were 12 males and 9 females with mean age of 61 years (16-79) and mean follow-up of 5.8 years (2-19.2). Tumor stage was IB in 20 and IIIB in one; mean tumor size was 10.5 cm. Fourteen patients underwent combined anterior-posterior resection and 7 posterior resection alone; 18 received adjuvant radiotherapy. After treatment, bowel and bladder control were present in 4 and 5 patients, respectively. Complications included: wound infection (4), other wound complications (9), fistula (2), deep vein thrombosis (1), and pulmonary embolism (1). Median survival was 7.2 years. Eight (40%) had local recurrence and 4 (19%) metastatic disease. Mean disease-free interval before recurrence was 2.5 years (1-5). No patient (n = 8) treated in the past 9 years has had local or distant disease. Patients treated for recurrent tumor survived 5.7 years on average (range, 0.8-9) after the first recurrence. The only risk factor for tumor recurrence was proximal tumor extent (P = 0.05) There was a statistically significant association between recurrence and survival (RR = 3.8; 95% confidence interval, 1.0-15.3; P = 0.04). CONCLUSION: Despite the complications, increased long-term survival can be achieved with treatment. Proximal tumor extent may be related to recurrence and survival. Recurrence rates have diminished over time, emphasizing the importance of an experienced multidisciplinary surgical team. LEVEL OF EVIDENCE: N/A.
Authors: S Stacchiotti; A Gronchi; P Fossati; T Akiyama; C Alapetite; M Baumann; J Y Blay; S Bolle; S Boriani; P Bruzzi; R Capanna; A Caraceni; R Casadei; V Colia; J Debus; T Delaney; A Desai; P Dileo; S Dijkstra; F Doglietto; A Flanagan; S Froelich; P A Gardner; H Gelderblom; Z L Gokaslan; R Haas; C Heery; N Hindi; P Hohenberger; F Hornicek; R Imai; L Jeys; R L Jones; B Kasper; A Kawai; M Krengli; A Leithner; I Logowska; J Martin Broto; D Mazzatenta; C Morosi; P Nicolai; O J Norum; S Patel; N Penel; P Picci; S Pilotti; S Radaelli; F Ricchini; P Rutkowski; S Scheipl; C Sen; E Tamborini; K A Thornton; B Timmermann; V Torri; P U Tunn; M Uhl; Y Yamada; D C Weber; D Vanel; P P Varga; C L A Vleggeert-Lankamp; P G Casali; J Sommer Journal: Ann Oncol Date: 2017-06-01 Impact factor: 32.976
Authors: Daniel Kerekes; C Rory Goodwin; A Karim Ahmed; Jorrit-Jan Verlaan; Chetan Bettegowda; Nancy Abu-Bonsrah; Daniel M Sciubba Journal: Global Spine J Date: 2018-05-30
Authors: Tilman Bostel; Matthias Mattke; Nils Henrik Nicolay; Thomas Welzel; Daniel Wollschläger; Sati Akbaba; Arnulf Mayer; Tanja Sprave; Jürgen Debus; Matthias Uhl Journal: Radiat Oncol Date: 2020-08-24 Impact factor: 3.481