Operative treatment of sacrococcygeal chordoma. A review of twenty-one cases.
Between 1972 and 1992, twenty-one patients had a primary operation for the treatment of a sacrococcygeal chordoma; seventeen had had a diagnostic biopsy elsewhere. The average age at the time of the operation was fifty-five years (range, six to seventy-eight years); fourteen patients were male and seven were female. In all patients, a posterior approach was used, even for resections at the cephalic levels of the sacrum. In addition, sixteen of the twenty-one patients were treated with adjuvant radiation therapy. Four patients died; three died of metastatic chordoma. Of the remaining seventeen patients, fifteen were apparently free of disease and had not had a local recurrence at the time of the latest follow-up examination. The average duration of follow-up for these fifteen patients was four and one-half years. Of the nine patients who were followed for at least five years, seven were disease-free at the latest follow-up evaluation. Of the seven patients in whom both second sacral roots were the most caudad nerve-roots spared, four had normal bladder control and five had normal bowel control. Of the four patients in whom the most caudad nerve-roots spared were the first sacral or more cephalic roots, all had impaired bladder control, one had impaired bowel control, and three had a colostomy.
Samson
I R
IR
Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston 02114.
Springfield
D S
DS
Suit
H D
HD
Mankin
H J
HJ
D000328:Adult; D000368:Aged; D002648:Child; D002817:Chordoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome