title: Sacral chordoma: management of a rare disease in a tertiary hospital.
abstract: BACKGROUND
  Chordoma is a rare malignant bone tumor. The outcome depends on the adequate surgical treatment with complete excision of the tumor with microscopic clear margins.
  
  
  METHODS
  We performed a retrospective review of 13 cases of chordomas operated in our center between 1988 and 2009.
  
  
  RESULTS
  All cases were treated with wide excision. Inadequate margins were found in seven patients. There were complications in ten patients and long-term sequels in 11 patients. Nine had recurrence within the first 2 years, six of which had inadequate margins. Five had metastatic disease, three of them with inadequate margins. During the follow-up, four patients died. In a posterior review, three patients survive and all of them had clear margins.
  
  
  CONCLUSIONS
  In our experience, the best treatment is complete excision of the tumor with clear microscopic margins. When this is not possible, local recurrences increase and survival rate decreases.
authors.affiliation: Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, C/Buenos Aires, 5. 1° 2, 28822 Coslada, Madrid, Spain. ghada_housari@yahoo.es
authors.forename: Gada
authors.initials: G
authors.lastname: Housari
authors.forename: Mariana
authors.initials: M
authors.lastname: González
authors.forename: Purificación
authors.initials: P
authors.lastname: Calero
authors.forename: Rafael
authors.initials: R
authors.lastname: Beni
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lobo
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002817:Chordoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D035583:Rare Diseases / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology* / Q000601:surgery; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D047368:Tumor Burden