Current Approaches in the Diagnosis, Treatment and Management of Sacral Chordomas

Abstract

Objectives: Sacral chordoma (SC) is a rare, aggressive tumor with a high recurrence rate and originates from notochordal remnants. SC is difficult to differentiate with its non-specific symptoms such as lower back pain. Surgical treatment and radiotherapy are first-line treatments. Resection with wide margins is vital for the prevention of recurrence. Materials and Methods: Nine patients diagnosed with SC between January 2014 and December 2021 were retrospectively analyzed. All adult patients with SC were included in the study. Pediatric population was excluded from the study. Pathology, radiology and surgical records of the patients’ were used. Mean age was 53.2. Results: Two out of 9 patients died during follow-up and 5 patients had local recurrence. No metastasis was observed. Conclusion: Current evidence shows that surgical treatment is necessary for SC’s treatment. Radiotherapy is also an important aspect of the treatment. Existing evidence should be meta-analyzed for a better understanding of SC’s treatment and outcomes.

Keywords

• Chordoma
• Sacrum
• Recurrence

Sakral Kordoma Tanı ve Tedavisinde Güncel Yaklaşımlar

Abstract

Amaç: Sakral kordoma (SK), yüksek nüks oranına sahip nadir ve agresif bir tümördür ve notokord kalıntılarından kaynaklanır. SK, alt sırt ağrısı gibi spesifik olmayan semptomlarıyla diğer patolojilerden ayırt edilmesi zor bir durumdur. Cerrahi tedavi ve radyoterapi birinci basamak tedavilerdir. Geniş sınırlarla rezeksiyon, nüksün önlenmesi için öneme sahiptir. Gereç ve Yöntem: Ocak 2014 ile Aralık 2021 tarihleri arasında SK tanısı konmuş 9 hasta retrospektif olarak analiz edildi. Tüm erişkin hastalar çalışmaya dahil edildi. Pediatrik popülasyon çalışma dışı bırakıldı. Hastaların patoloji, radyoloji ve cerrahi kayıtları kullanıldı. Ortalama yaş 53,2 idi. Bulgular: Dokuz hastanın takip süreci boyunca 2’si hayatını kaybetti ve 5 hastada lokal nüks görüldü. Metastaz gözlenmedi. Sonuç: Mevcut kanıtlar, SK tedavisi için cerrahi müdahalenin gerekliliğini göstermektedir. Radyoterapi de tedavinin önemli bir kısmını oluşturmaktadır. SK tedavisinin ve sonuçlarının daha iyi anlaşılması için mevcut kanıtlarla yapılacak meta-analize ihtiyaç duyulmaktadır.

Keywords

• Kordoma
• Sacrum
• Nüks

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