Abstract
Chordoma is low grade, locally aggressive and mainly in the sacrococcygeal region. Treatment is a combination of surgery and radiotherapy. We reviewed, to determine our outcome and functional deficits, the cases treated over 15 years by the senior author.
Out of 26 chordoma’s referred 14 were in the sacrococcygeal region. We reviewed them retrospectively looking at presentation, diagnosis, surgical approach, neurological result, complications and survival.
The mean age was 55 years (range 26–80 years), 9 males and 5 females. 13 were primary and 1 was recurrent. Patients reported 18 months of symptoms prior to diagnosis. The tumour sites were S1-5, S2-2, S3-2, S4-3, S5-1 and coccyx −1. Surgery was performed via an anterior/posterior-combined approach in 10, a posterior approach in 2, anterior in 1 and posterior/perineal combined in 1. Complete excision was possible in 11 cases. Surgical resection with radiotherapy was used for inadequate surgical margins, in 3 cases. Neurologically we found that we needed an intact unilateral S3 nerve root for continence in our series. All patients had minor wound complications, 2 wounds required further surgical intervention, and there were 2 cardiac arrhythmias, 1 pulmonary embolus. There were 5 recurrences, 3 were local and 2 metastatic. The survival data for 5 and 7 years is 88% and 71% respectively. Our disease free survival at 5 and 7-years was 44% and 57% respectively.
We achieved an excellent 5 and 7-year survival in our series. The results following complete excision were best, but those treated with adjuvant radiotherapy also responded well. We saw that a solitary S3 nerve root is needed for continence. Treating by a combined anterior/ posterior approach suggests improved survival.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
