Can local recurrence of a sacral chordoma be treated by further surgery?
The purpose of this study was to evaluate the long-term outcome of patients with a sacral chordoma and the surgical management of locally recurrent disease. Between October 1990 and August 2013 we operated on 54 consecutive patients with a sacral chordoma. There were 34 men and 20 women with a mean age of 60 years (25 to 86). The mean maximum diameter of the tumour was 9.3 cm (3 to 20). The mean follow-up was 7.8 years (2 months to 23.4 years). The disease-specific survival was 82% at five years, 57% at ten years and 45% at 15 years. The local recurrence-free survival was 49% at five years, 37% at ten years and 20% at 15 years. Local recurrence occurred in 30 patients (56%) at a mean of 3.8 years (3 months to 13 years) post-operatively. Survival after the treatment of recurrence was 89% at two years, 56% at five years and 19% at ten years. Of nine patients who had complete resection of a recurrence, one died after 72 months and eight remain disease-free. Incomplete resection of recurrent disease resulted in a survival of 54% at two years and 36% at five years. For 12 patients with a local recurrence who were treated palliatively, survival was 81% at two years and 31% at five years. A wide margin of resection gave the best chance of long-term survival and complete resection of local recurrence the best chance of control of disease.
The Royal Orthopaedic Hospital Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
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C
Xie
The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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N
Whalley
The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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K
Adasonla
The Royal Orthopaedic Hospital Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
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R
Grimer
The Royal Orthopaedic Hospital Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
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L
Jeys
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002817:Chordoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019233:Retreatment; D012189:Retrospective Studies; D012447:Sacrum; D013125:Spinal Neoplasms / Q000601:surgery*
Chordoma; Prognosis; Recurrence; Surgery