Long-Term Clinical Outcomes Following En Bloc Resections for Sacral Chordomas and Chondrosarcomas A Series of Twenty Consecutive Patients
Long-Term Clinical Outcomes Following En Bloc Resections for Sacral Chordomas and Chondrosarcomas A Series of Twenty Consecutive Patients
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DOI：
10.1097/brs.0b013e3181b61b90
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发表时间：
2009-09-15
期刊：
影响因子：
3
通讯作者：
Gokaslan, Ziya L.
中科院分区：
文献类型：
--
作者：
Hsieh, Patrick C.;Xu, Risheng;Gokaslan, Ziya L.
研究设计。对连续20例接受骶骨脊索瘤和软骨肉瘤整块切除术的患者进行回顾性研究。目的。评估骶骨脊索瘤和软骨肉瘤整体肿瘤切除后的功能和肿瘤学结果。背景数据摘要。脊索瘤和软骨肉瘤是成人骶骨最常见的两种恶性原发性肿瘤。迄今为止，很少有对这些肿瘤进行整块切除的大型临床系列。方法。对机构原发性脊柱肿瘤手术数据库进行了回顾性审查。该研究纳入了 20 名 2002 年至 2007 年间连续接受原发性整块肿瘤切除术的骶骨脊索瘤和软骨肉瘤患者。对这些患者的手术切缘、围手术期并发症和术后功能状态进行分析。使用Kaplan-Meier方法确定整体肿瘤切除后的无病生存率。结果。研究队列包括 8 名男性和 12 名女性，平均年龄 53.5 岁，男性随访时间为 47.8 个月。 14 名患者实现了广泛或边缘整块切除。在另外 6 名患者中，在手术边缘发现了肿瘤，他们被认为进行了污染/病灶内切除。该系列的 30 天围手术期并发症包括 1 例肺栓塞死亡和 9 例伤口并发症。 40%的患者术后膀胱和肠道功能正常，而60%的患者膀胱和肠道功能部分或完全丧失。除 2 名患者外，该组中的所有患者在手术后均保持卧床休息。广泛或边缘整块肿瘤切除患者的平均无病生存期为51个月，但污染/病灶内切除患者的平均无病生存期仅为17.5个月。结论。骶骨脊索瘤和软骨肉瘤的广泛或边缘整块切除与无病生存率的显着改善以及可接受的围手术期发病率相关。
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.