Analysis of morbidity and mortality in patients with primary bone tumors who underwent sacrectomy: A systematic review

Silva, Mayara Branco e; Martins, Samilly Conceição Maia; Garofo, Karen Voltan; Hanasilo, Carlos Eduardo Hideo; Etchebehere, Maurício

doi:10.1016/j.jbo.2022.100445

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…In particular, wound-healing disorders and wound dehiscence, including infections, are frequent and described in all current studies [1,17,19,54,63]. The described rate of infections following sacrectomy varies between 25 and 60% [1,44,58]. In the present study, it was higher, with 63%, including infections (37%) and wound-healing disorders (26%).…”

Section: Complicationssupporting

confidence: 49%

“…Among the types of intraoperative complications, massive intraoperative blood loss with subsequent hemorrhagic shock, rectal perforation and pulmonary thromboembolism are reported to represent the most frequent causes, leading to intra-or early postoperative death in less than 3% [58]. In the present study, there was no intra-or very early postoperative death due to one of the above-mentioned reasons, as only one patient died of infection-induced multiorgan failure 5 months after surgery.…”

Section: Complicationssupporting

confidence: 41%

“…The most prevalent postoperative complications after sacrectomy represent surgical site infection, wound dehiscence, mechanical instrumentation failure, secondary cerebrospinal fluid leakage, urinary disorders and sensomotor dysfunction/fecal incontinence [1,58]. However, postoperative neurological deficits with either S1 dysfunction or loss of sphincter control following high or total sacrectomies are difficult to address in the current study, as they are an almost-invariable consequence of oncologically necessary sacralnerve transections.…”

Section: Complicationsmentioning

confidence: 85%

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Surgical and Oncologic Outcome following Sacrectomy for Primary Malignant Bone Tumors and Locally Recurrent Rectal Cancer

Weidlich,

Schaser,

Weitz

et al. 2024

Cancers

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Introduction: Bone sarcoma or direct pelvic carcinoma invasion of the sacrum represent indications for partial or total sacrectomy. The aim was to describe the oncosurgical management and complication profile and to analyze our own outcome results following sacrectomy. Methods: In a retrospective analysis, 27 patients (n = 8/10/9 sarcoma/chordoma/locally recurrent rectal cancer (LRRC)) were included. There was total sacrectomy in 9 (incl. combined L5 en bloc spondylectomy in 2), partial in 10 and hemisacrectomy in 8 patients. In 12 patients, resection was navigation-assisted. For reconstruction, an omentoplasty, VRAM-flap or spinopelvic fixation was performed in 20, 10 and 13 patients, respectively. Results: With a median follow-up (FU) of 15 months, the FU rate was 93%. R0-resection was seen in 81.5% (no significant difference using navigation), and 81.5% of patients suffered from one or more minor-to-moderate complications (especially wound-healing disorders/infection). The median overall survival was 70 months. Local recurrence occurred in 20%, while 44% developed metastases and five patients died of disease. Conclusions: Resection of sacral tumors is challenging and associated with a high complication profile. Interdisciplinary cooperation with visceral/vascular and plastic surgery is essential. In chordoma patients, systemic tumor control is favorable compared to LRRC and sarcomas. Navigation offers gain in intraoperative orientation, even if there currently seems to be no oncological benefit. Complete surgical resection offers long-term survival to patients undergoing sacrectomy for a variety of complex diseases.

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Section: Complicationssupporting

confidence: 49%

Section: Complicationssupporting

confidence: 41%

Section: Complicationsmentioning

confidence: 85%

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Surgical and Oncologic Outcome following Sacrectomy for Primary Malignant Bone Tumors and Locally Recurrent Rectal Cancer

Weidlich,

Schaser,

Weitz

et al. 2024

Cancers

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“…Regarding the early postoperative complications after such a challenging tumor resection surgery, WRCs are by far the most common events [ 4 , 16 , 17 , 18 , 19 , 22 , 30 , 31 , 32 , 33 , 34 ], with reported rates up to 57.8% [ 35 ]. Two large cohorts of patients with sacral chordomas from Mayo Clinic report 68% overall complication rates and 32% WRC rates after sacrectomy [ 19 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Two large cohorts of patients with sacral chordomas from Mayo Clinic report 68% overall complication rates and 32% WRC rates after sacrectomy [ 19 , 36 ]. In a recent systematic review of 13 analyzed studies and 384 sacrectomies, Branco E Silva M et al report reoperations rates of 28% due to WRCs [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome after Surgical Treatment of Sacral Chordomas: A Single-Center Retrospective Cohort of 27 Patients

Goumenos,

Kakouratos,

Trikoupis

et al. 2024

Cancers

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Introduction: The aims of our study were (1) to determine disease-specific and disease-free survival after the en-bloc resection of sacral chordomas and (2) to investigate potential risk factors for tumor recurrence and major postoperative wound-related complications. Methods: We retrospectively analyzed 27 consecutive patients with sacral chordomas who were surgically treated in our institution between 2004 and 2022. Three patients (11.1%) had a recurrent tumor and four patients (14.8%) had history of a second primary solid tumor prior to or after their sacral chordoma. A combined anterior and posterior approach, colostomy, plastic reconstruction, and spinopelvic instrumentation were necessitated in 51.9%, 29.6%, 37%, and 7.4% of cases, respectively. The mean duration of follow-up was 58 ± 41 months (range= 12–170). Death-related-to-disease, disease recurrence, and major surgical site complications were analyzed using Kaplan–Meier survival analysis, and investigation of the respective risk factors was performed with Cox hazard regression. Results: The estimated 5-year and 10-year disease-specific survival was 75.3% (95% CI = 49.1–87.5%) and 52.7% (95% CI = 31–73.8%), respectively. The estimated 1-year, 5-year, and 10-year disease-free survival regarding local and distant disease recurrence was 80.4% (95% CI = 60.9–91.1%), 53.9% (95% CI = 24.6–66.3%), and 38.5% (95% CI = 16.3–56.2%), respectively. The mean survival of the recurred patients was 61.7 ± 33.4 months after their tumor resection surgery. Conclusions: Despite the high relapse rates and perioperative morbidity, long-term patient survival is not severely impaired. Positive or less than 2 mm negative resection margins have a significant association with disease progression.

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Perioperative Blood Transfusions and Cancer Progression: A Narrative Review

Abou Daher,

Heppell,

Lopez-Plaza

et al. 2024

Curr Oncol Rep

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Analysis of morbidity and mortality in patients with primary bone tumors who underwent sacrectomy: A systematic review

Cited by 5 publications

References 34 publications

Surgical and Oncologic Outcome following Sacrectomy for Primary Malignant Bone Tumors and Locally Recurrent Rectal Cancer

Surgical and Oncologic Outcome following Sacrectomy for Primary Malignant Bone Tumors and Locally Recurrent Rectal Cancer

Clinical Outcome after Surgical Treatment of Sacral Chordomas: A Single-Center Retrospective Cohort of 27 Patients

Perioperative Blood Transfusions and Cancer Progression: A Narrative Review

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