Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas

A series of twenty consecutive patients

Patrick C. Hsieh, Risheng Xu, Daniel Sciubba, Matthew J. McGirt, Clarke Nelson, Timothy F Witham, Jean Paul Wolinksy, Ziya L. Gokaslan

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN. Retrospective study of 20 consecutive patients who underwent en bloc tumor excision of sacral chordomas and chondrosarcomas. OBJECTIVE. To evaluate the functional and oncological outcomes following en bloc tumor excision for sacral chordomas and chondrosarcomas. SUMMARY OF BACKGROUND DATA. Chordomas and chondrosarcomas are 2 of the most common malignant primary tumors of the sacrum in adults. To date, few large clinical series with en bloc resection of these tumors exist. METHODS. An institutional primary spine tumor surgical database was retrospective reviewed. Twenty consecutive patients with sacral chordomas and chondrosarcomas who underwent primary en bloc tumor excisions from 2002 to 2007 were included in the study. Surgical margin, perioperative complications, and postoperative functional status in these patients were analyzed. Disease-free survival following en bloc tumor excision was determined using the Kaplan-Meier method. RESULTS. The study cohort included 8 males and 12 females with an average age of 53.5 years and a man follow-up of 47.8 months. Wide or marginal en bloc resection was achieved in 14 patients. In 6 other patients, tumor was identified at the surgical margins, and they were considered to have contaminated/intralesional resections. The 30-day perioperative morbidities in this series included 1 death from pulmonary embolism and 9 wound complications. Forty percent of the patients had normal bladder and bowel functions after surgery, while 60% of the patients had partial or complete loss of bladder and bowel functions. All but 2 patients in this group remained ambulatory after the surgery. The mean disease-free survival for patients with wide or marginal en bloc tumor excisions was 51 months, but the mean disease-free survival was only 17.5 months for patients who had contaminated/intralesional resections. CONCLUSION. Wide or marginal en bloc excision of sacral chordoma and chondrosarcoma is associated with significant improvement in disease-free survival with acceptable perioperative morbidity rate.

Original languageEnglish (US)
Pages (from-to)2233-2239
Number of pages7
JournalSpine
Volume34
Issue number20
DOIs
StatePublished - Sep 2009

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Chordoma
Chondrosarcoma
Neoplasms
Disease-Free Survival
Urinary Bladder
Morbidity
Sacrum
Ambulatory Surgical Procedures
Pulmonary Embolism
Spine
Cohort Studies
Retrospective Studies
Databases

Keywords

  • Chondrosarcoma
  • Chordoma
  • En bloc excision
  • Primary spine tumor
  • Sacral tumor
  • Sacrectomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas : A series of twenty consecutive patients. / Hsieh, Patrick C.; Xu, Risheng; Sciubba, Daniel; McGirt, Matthew J.; Nelson, Clarke; Witham, Timothy F; Wolinksy, Jean Paul; Gokaslan, Ziya L.

In: Spine, Vol. 34, No. 20, 09.2009, p. 2233-2239.

Research output: Contribution to journalArticle

Hsieh, Patrick C. ; Xu, Risheng ; Sciubba, Daniel ; McGirt, Matthew J. ; Nelson, Clarke ; Witham, Timothy F ; Wolinksy, Jean Paul ; Gokaslan, Ziya L. / Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas : A series of twenty consecutive patients. In: Spine. 2009 ; Vol. 34, No. 20. pp. 2233-2239.
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abstract = "STUDY DESIGN. Retrospective study of 20 consecutive patients who underwent en bloc tumor excision of sacral chordomas and chondrosarcomas. OBJECTIVE. To evaluate the functional and oncological outcomes following en bloc tumor excision for sacral chordomas and chondrosarcomas. SUMMARY OF BACKGROUND DATA. Chordomas and chondrosarcomas are 2 of the most common malignant primary tumors of the sacrum in adults. To date, few large clinical series with en bloc resection of these tumors exist. METHODS. An institutional primary spine tumor surgical database was retrospective reviewed. Twenty consecutive patients with sacral chordomas and chondrosarcomas who underwent primary en bloc tumor excisions from 2002 to 2007 were included in the study. Surgical margin, perioperative complications, and postoperative functional status in these patients were analyzed. Disease-free survival following en bloc tumor excision was determined using the Kaplan-Meier method. RESULTS. The study cohort included 8 males and 12 females with an average age of 53.5 years and a man follow-up of 47.8 months. Wide or marginal en bloc resection was achieved in 14 patients. In 6 other patients, tumor was identified at the surgical margins, and they were considered to have contaminated/intralesional resections. The 30-day perioperative morbidities in this series included 1 death from pulmonary embolism and 9 wound complications. Forty percent of the patients had normal bladder and bowel functions after surgery, while 60{\%} of the patients had partial or complete loss of bladder and bowel functions. All but 2 patients in this group remained ambulatory after the surgery. The mean disease-free survival for patients with wide or marginal en bloc tumor excisions was 51 months, but the mean disease-free survival was only 17.5 months for patients who had contaminated/intralesional resections. CONCLUSION. Wide or marginal en bloc excision of sacral chordoma and chondrosarcoma is associated with significant improvement in disease-free survival with acceptable perioperative morbidity rate.",
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T1 - Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas

T2 - A series of twenty consecutive patients

AU - Hsieh, Patrick C.

AU - Xu, Risheng

AU - Sciubba, Daniel

AU - McGirt, Matthew J.

AU - Nelson, Clarke

AU - Witham, Timothy F

AU - Wolinksy, Jean Paul

AU - Gokaslan, Ziya L.

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N2 - STUDY DESIGN. Retrospective study of 20 consecutive patients who underwent en bloc tumor excision of sacral chordomas and chondrosarcomas. OBJECTIVE. To evaluate the functional and oncological outcomes following en bloc tumor excision for sacral chordomas and chondrosarcomas. SUMMARY OF BACKGROUND DATA. Chordomas and chondrosarcomas are 2 of the most common malignant primary tumors of the sacrum in adults. To date, few large clinical series with en bloc resection of these tumors exist. METHODS. An institutional primary spine tumor surgical database was retrospective reviewed. Twenty consecutive patients with sacral chordomas and chondrosarcomas who underwent primary en bloc tumor excisions from 2002 to 2007 were included in the study. Surgical margin, perioperative complications, and postoperative functional status in these patients were analyzed. Disease-free survival following en bloc tumor excision was determined using the Kaplan-Meier method. RESULTS. The study cohort included 8 males and 12 females with an average age of 53.5 years and a man follow-up of 47.8 months. Wide or marginal en bloc resection was achieved in 14 patients. In 6 other patients, tumor was identified at the surgical margins, and they were considered to have contaminated/intralesional resections. The 30-day perioperative morbidities in this series included 1 death from pulmonary embolism and 9 wound complications. Forty percent of the patients had normal bladder and bowel functions after surgery, while 60% of the patients had partial or complete loss of bladder and bowel functions. All but 2 patients in this group remained ambulatory after the surgery. The mean disease-free survival for patients with wide or marginal en bloc tumor excisions was 51 months, but the mean disease-free survival was only 17.5 months for patients who had contaminated/intralesional resections. CONCLUSION. Wide or marginal en bloc excision of sacral chordoma and chondrosarcoma is associated with significant improvement in disease-free survival with acceptable perioperative morbidity rate.

AB - STUDY DESIGN. Retrospective study of 20 consecutive patients who underwent en bloc tumor excision of sacral chordomas and chondrosarcomas. OBJECTIVE. To evaluate the functional and oncological outcomes following en bloc tumor excision for sacral chordomas and chondrosarcomas. SUMMARY OF BACKGROUND DATA. Chordomas and chondrosarcomas are 2 of the most common malignant primary tumors of the sacrum in adults. To date, few large clinical series with en bloc resection of these tumors exist. METHODS. An institutional primary spine tumor surgical database was retrospective reviewed. Twenty consecutive patients with sacral chordomas and chondrosarcomas who underwent primary en bloc tumor excisions from 2002 to 2007 were included in the study. Surgical margin, perioperative complications, and postoperative functional status in these patients were analyzed. Disease-free survival following en bloc tumor excision was determined using the Kaplan-Meier method. RESULTS. The study cohort included 8 males and 12 females with an average age of 53.5 years and a man follow-up of 47.8 months. Wide or marginal en bloc resection was achieved in 14 patients. In 6 other patients, tumor was identified at the surgical margins, and they were considered to have contaminated/intralesional resections. The 30-day perioperative morbidities in this series included 1 death from pulmonary embolism and 9 wound complications. Forty percent of the patients had normal bladder and bowel functions after surgery, while 60% of the patients had partial or complete loss of bladder and bowel functions. All but 2 patients in this group remained ambulatory after the surgery. The mean disease-free survival for patients with wide or marginal en bloc tumor excisions was 51 months, but the mean disease-free survival was only 17.5 months for patients who had contaminated/intralesional resections. CONCLUSION. Wide or marginal en bloc excision of sacral chordoma and chondrosarcoma is associated with significant improvement in disease-free survival with acceptable perioperative morbidity rate.

KW - Chondrosarcoma

KW - Chordoma

KW - En bloc excision

KW - Primary spine tumor

KW - Sacral tumor

KW - Sacrectomy

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