Analysis of risk factors for recurrence after the resection of sacral chordoma combined with embolization.
BACKGROUND
Although several authors have already reported on the high local recurrence rate of sacral chordomas after surgical resection, there are no reports on the risk factors for recurrence after resection when combined with preoperative tumor-related blood vessel embolism by digital subtraction angiography (DSA) technique.


OBJECTIVE
To investigate the factors related to the continuous disease-free survival time (CDFS) after the resection of sacral chordomas combined with embolization.


METHODS
Retrospective review of the signs, images, and immunohistochemical data of patients with sacral chordomas treated with an initial operation combined with transcatheter arterial embolization.


METHODS
Twenty-two patients with sacral chordomas received initial resection combined with transcatheter arterial embolization.


METHODS
Recurrence, proliferating cell nuclear antigen (PCNA) expression, basic fibroblast growth factor (bFGF) expression, CDFS.


METHODS
All cases were selected and followed for an average of 39.2 months. The roles of gender, age, tumor size, tumor location, surgical method, radiation therapy, PCNA expression, and bFGF expression in local recurrence were analyzed using the log-rank test.


RESULTS
Sacral chordomas recurred in eight of 22 cases. The CDFS was significantly greater in tumors located below S3 as compared with those above S3. When evaluating PCNA and bFGF expression levels, the CDFS was greater in low expressions rather than high expressions. It was determined that the surgical method used was of prognostic significance to the CDFS.


CONCLUSIONS
Higher tumor location and higher expressions of PCNA and bFGF will lead to a shorter CDFS. Resecting the tumor as completely as possible will decrease the chances of local recurrence of sacral chordomas.
Yang
Huilin
H
Department of Orthopaedic Surgery, First Hospital Affiliated to Suzhou University, Suzhou, China.
Zhu
Lifan
L
Ebraheim
Nabil A
NA
Liu
Xiaochen
X
Castillo
Sharmaine
S
Tang
Tiansi
T
Liu
Jiayong
J
Cui
Hongjuan
H
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002817:Chordoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012447:Sacrum / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D055815:Young Adult
D014408:Biomarkers, Tumor