Surgical management of sacral chordoma

Treatment results of 17 patients who were diagnosed with sacral chordoma between 1993 and 2007, were analyzed retrospectively. The mean duration of symptoms was 30.2 months. The mean tumour size was 10.7 cm; the location was S2 or more proximal in ten-patients. A wide resection was achieved in 14 patients, a marginal resection in one patient and two patients had intralesional excision. Seven patients had a recurrence after a mean time interval of 36.3 months. Wound dehiscence and infection were the major problems. Four patients required continuous urinary catheterization because of incontinence, and ten patients had colostomy or ileostomy simultaneously with tumour resection. This study showed that tumour size and a wide surgical margin are importance factors for survival in chordoma patients. Use of a combined anterior and posterior approach could increase the chance of achieving a wide margin. A multidisciplinary approach is required to achieve this goal.