Sacral chordoma en-bloc resection and lumbar-iliac stabilization

Okaji, Ruy Yoshiaki; Silveira, José Marcondes Da; Nakano, Milton Kanenori; Kiuti, Leandro Tomokazu; Maiorano, M

doi:10.1590/s0004-282x2008000300023

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…9 Sacral chordoma results in chronic back pain or urinary/bowel dysfunction due to nerve root compression. 20 Most of the sacrococcygeal chordomas are initially presented with a considerable extra axial tumoral growth, 22 and often palpated as a mass on rectal examination. 13,14 Anterior expansion into the presacral space with unilateral impingement of S2 or S3 is usually associated with mild -to-moderate bladder, bowel, and sexual dysfunction, while bilateral affection usually result in complete dysfunction.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Cordoma sacrococcígeo: revisión del tema

Sánchez Torres,

Pulido Torres,

Espinoza Velazco

et al. 2024

Cir Columna

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Chordoma is a malignant primary tumor that resembles notochordal differentiation. Its maximum incidence is between the fifth and sixth decades of life, and men are affected more frequently than women in a ratio of 2:1; half of cases are located in the sacrococcygeal region. They are uncommon slow-growing lesions that originate in the midline. Its treatment is surgical through wide or radical resection. Total sacrectomies involve lumbopelvic dissociation, therefore it is important to stabilize the area and achieve adequate coverage of reconstruction. Treatment of the lesions involve great operational complexity and generate neurological sequelae mainly related to sphincter control, depending on the level resection. The incidence of morbidity and mortality in sacrococcygeal resections is high. Patients diagnosed with chordoma should be treated in highly specialized units. RESUMENEl cordoma es un tumor maligno primario que resume diferenciación notocordal. Su máxima incidencia es entre la quinta y sexta décadas de la vida, y los hombres son afectados más frecuentemente que las mujeres en relación 2:1; la mitad de los casos se localizan en la región sacrocoxígea. Son lesiones infrecuentes de lento crecimiento que se originan en la línea media. Su tratamiento es quirúrgico mediante resección amplia o radical. Las sacrectomías totales implican disociación lumbopélvica, por ende es importante estabilizar la zona y lograr una cobertura adecuada de la reconstrucción. Son lesiones cuyo tratamiento implica gran complejidad operativa y genera secuelas neurológicas principalmente relacionadas con el control de esfínteres, las que dependerán del nivel de resección. La incidencia de morbilidad y mortalidad en resecciones sacrococcígeas, es alta. Los pacientes con diagnóstico de cordoma deben ser tratados en unidades altamente especializadas.

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Section: Clinical Featuresmentioning

confidence: 99%

“…9 Metastasis are not frequent and most of the pathologists consider conventional chordomas as on a low malignant degree. 22 Conventional chordoma is the most common type of chordoma. 11,15…”

Section: Conventional Chordomamentioning

confidence: 99%

Cordoma sacrococcígeo: revisión del tema

Sánchez Torres,

Pulido Torres,

Espinoza Velazco

et al. 2024

Cir Columna

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“…18 Surgery continues to be the primary modality in the management of chordomas. Rates of local recurrence, as well as survival, appear to be dependent on the achievement of negative surgical margins; [30][31][32] intralesional resections are associated with increased local recurrence and decreased survival. 33 Chordomas are highly recurrent, making their clinical progression very similar to that of the majority of the malignant tumors.…”

Section: Chordomamentioning

confidence: 99%

“…29 The functional consequences for the patient should be clearly discussed in the preoperative evaluation. 31 Chemotherapy and conventional radiotherapy have not been proven to be effective treatment methods for sacral chordomas. 32,33…”

Section: Chordomamentioning

confidence: 99%

Tumores sacros y sacrectomía: una perspectiva global

Sánchez-Torres,

Pulido Torres,

Espinoza Velazco

et al. 2024

Ortho-Tips

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Sacral tumors are mainly metastatic in origin, while benign lesions are usually benign aggressive or low-grade malignancies. Symptoms of these lesions are non-specific and usually are diagnosed in advanced stages, causing major therapeutic difficulties that require a multidisciplinary approach. The most frequent malignant primary tumors of the sacrum, such as chordoma and chondrosarcoma, require special mention due to the complexity of their surgical management. Sacrectomy implies discontinuity between the mobile spine and fixed pelvis, in addition to important neurological sequelae mainly focused on rectal and bladder sphincter control. These are very complex procedures with a high incidence of serious perioperative complications. In general terms, sacral tumors, like the rest of the axial neoplasms, have a worse prognosis than their appendicular counterpart and must be managed in specialized centers and by highly trained specialized medical staff. The objective of the present review is to generate a concrete but current presentation paper on a group of skeletal neoplasms whose prognosis depends largely on rapid diagnosis and adequate treatment.

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Les chordomes

et al. 2014

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Many different pathologies derived from the notochord can be observed: some are remnants, some may be precursors of chordomas and some have similar features but are probably not genuine chordomas. To-day, immuno-histological studies should permit to differentiate them from real chordomas. Improving knowledge of molecular biology raises hopes for complementary treatments but to date the quality of surgical resection is still the main factor of prognosis. Complementary protontherapy seems useful, especially in skull base chordomas, which have better overall results than those of the craniocervical junction and of the cervical spine. However, we are still lacking an intrinsic marker of evolution to differentiate the slow growing chordomas with an indolent evolution from aggressive types leading rapidly to recurrence and death on which more aggressive treatments should be applied.

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Sacral chordoma en-bloc resection and lumbar-iliac stabilization

Cited by 3 publications

References 12 publications

Cordoma sacrococcígeo: revisión del tema

Cordoma sacrococcígeo: revisión del tema

Tumores sacros y sacrectomía: una perspectiva global

Les chordomes

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