Introduction:The aims of our study were (1) to determine disease-specific and disease-free survival after the en-bloc resection of sacral chordomas and (2) to investigate potential risk factors for tumor recurrence and major postoperative wound-related complications.Methods:We retrospectively analyzed 27 consecutive patients with sacral chordomas who were surgically treated in our institution between 2004 and 2022. Three patients (11.1%) had a recurrent tumor and four patients (14.8%) had history of a second primary solid tumor prior to or after their sacral chordoma. A combined anterior and posterior approach, colostomy, plastic reconstruction, and spinopelvic instrumentation were necessitated in 51.9%, 29.6%, 37%, and 7.4% of cases, respectively. The mean duration of follow-up was 58 ± 41 months (range= 12–170). Death-related-to-disease, disease recurrence, and major surgical site complications were analyzed using Kaplan–Meier survival analysis, and investigation of the respective risk factors was performed with Cox hazard regression.Results:The estimated 5-year and 10-year disease-specific survival was 75.3% (95% CI = 49.1–87.5%) and 52.7% (95% CI = 31–73.8%), respectively. The estimated 1-year, 5-year, and 10-year disease-free survival regarding local and distant disease recurrence was 80.4% (95% CI = 60.9–91.1%), 53.9% (95% CI = 24.6–66.3%), and 38.5% (95% CI = 16.3–56.2%), respectively. The mean survival of the recurred patients was 61.7 ± 33.4 months after their tumor resection surgery.Conclusions:Despite the high relapse rates and perioperative morbidity, long-term patient survival is not severely impaired. Positive or less than 2 mm negative resection margins have a significant association with disease progression.
引言：本研究旨在（1）评估骶骨脊索瘤整块切除术后的疾病特异性生存率与无病生存率，并（2）探究肿瘤复发及术后重大伤口相关并发症的潜在风险因素。 方法：我们回顾性分析了2004年至2022年间在本机构连续接受手术治疗的27例骶骨脊索瘤患者。其中3例（11.1%）为复发性肿瘤，4例（14.8%）在骶骨脊索瘤确诊前后曾罹患第二原发实体肿瘤。51.9%的病例需采用前后联合入路手术，29.6%需行结肠造口术，37%需进行整形重建，7.4%需应用脊柱骨盆内固定术。平均随访时间为58±41个月（范围12-170个月）。采用Kaplan-Meier生存分析法评估疾病相关死亡、疾病复发及重大手术部位并发症情况，并通过Cox风险回归模型分析相关风险因素。 结果：估计5年与10年疾病特异性生存率分别为75.3%（95% CI=49.1-87.5%）和52.7%（95% CI=31-73.8%）。针对局部及远处疾病复发，估计1年、5年与10年无病生存率分别为80.4%（95% CI=60.9-91.1%）、53.9%（95% CI=24.6-66.3%）和38.5%（95% CI=16.3-56.2%）。复发患者肿瘤切除术后平均生存期为61.7±33.4个月。 结论：尽管存在较高的复发率及围手术期并发症发生率，患者的长期生存并未受到严重损害。手术切缘阳性或阴性边界小于2毫米与疾病进展存在显著相关性。
肿瘤(癌症)患者之家