[Primary malignant tumors of the sacrum]

The oncological and functional results of 16 patients with primary malignant sacral tumors (12 chordomas, 3 chondrosarcomas, 1 fibrosarcoma) during the past decade are reported. Dorsal approach was used in 10 cases, ventral or combined ventrodorsal procedure in 5 cases; in 1 case only biopsy was taken. Amputation of rectum with colostomy was necessary in 9 cases, ileosacral stabilization in 2 cases. Eight patients died, 5 of the disease and 3 of complications, with a mean survival time of 25.8 months. Local recurrence occurred in 4, distant metastases in 3 cases. Six of the 8 survivors--mean survival is 59 (21-112) months--showed good or excellent functional results according to the Enneking score system. Local complications, mostly wound healing problems, were observed in 9 (56%), neurological disorders in respect of the resected sacral nerve roots in 11 (68%) cases. The oncological and functional results after resection of primary malignant sacral tumors, especially of chordomas, justify radical surgical procedures sacrificing the sacral nerve roots.