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01-05-2015 | Original Article

Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival

Authors: Péter Pál Varga, Zsolt Szövérfi, Charles G. Fisher, Stefano Boriani, Ziya L. Gokaslan, Mark B. Dekutoski, Dean Chou, Nasir A. Quraishi, Jeremy J. Reynolds, Alessandro Luzzati, Richard Williams, Michael G. Fehlings, Niccole M. Germscheid, Aron Lazary, Laurence D. Rhines

Published in: European Spine Journal | Issue 5/2015

Abstract

Purpose

Sacral chordomas (SC) are rare, locally invasive, malignant neoplasms. Despite surgical resection and adjuvant therapies, local recurrence (LR) is common and overall survival (OS) is poor. The objective of this study was to identify prognostic factors that have an impact on the local recurrence-free survival (LRFS) and OS of patients with SC.

Methods

Utilizing the AOSpine Knowledge Forum Tumor multicenter ambispective database, surgically treated SC cases were identified. Cox regression modeling was used to assess the effect of several clinically relevant variables on OS and LRFS.

Results

A total of 167 patients with surgically treated SC were identified. The male/female ratio was 98/69 with a mean age of 57 ± 15 years at the time of surgery. The LR was 35 % (n = 57), death occurred in 30 % of patients (n = 50) during the study period. The median OS was 6 years post-surgery and LRFS was 4 years. In the univariate analysis, previous tumor surgery at the same site (P = 0.002), intralesional resection (P < 0.001), and larger tumor volume (P = 0.030) were significantly associated with LR. Increasing age (P < 0.001) and a preoperative motor deficit of C or D (P = 0.003) were significantly associated with poor OS, and nerve root sacrifice showed a trend towards significance (P = 0.088). In the multivariate models, previous surgery and intralesional resection were significantly related to LR, while increasing age and motor deficit of C or D were associated with poor OS.

Conclusions

This study identified two predictive variables for LRFS (previous tumor surgery and type of surgical resection) and two for OS (age and impaired motor function) in surgically treated SC patients. Our results indicate that en bloc resection reduces LR but does not influence OS. However, this was likely due to short follow-up (3.2 years).

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Title: Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival
Authors: Péter Pál Varga
Zsolt Szövérfi
Charles G. Fisher
Stefano Boriani
Ziya L. Gokaslan
Mark B. Dekutoski
Dean Chou
Nasir A. Quraishi
Jeremy J. Reynolds
Alessandro Luzzati
Richard Williams
Michael G. Fehlings
Niccole M. Germscheid
Aron Lazary
Laurence D. Rhines
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3728-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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