Recurrence and survival factors analysis of 171 cases of sacral chordoma in a single institute.

PURPOSE: To evaluate postoperative recurrence, survival and metastasis results and related factors of sacral chordoma.

METHODS: Between 1978 and 2013, a total of 171 patients with sacral chordoma were diagnosed at our institution and 162 cases underwent operation. The clinical characteristics, treatment and outcomes of all these patients were reviewed.

RESULTS: The 3-year recurrence free survival rate was 83.1%. The median recurrence free survival time was 73 ± 7.8 months. Tumor level in sacrum and surgical margin were significant factors influencing recurrence. Recurrence was significant factor influencing metastasis. One hundred and fifty-seven cases were followed up for an average of 55.6 months. 135 cases (86%) survived, 37 cases (23.6%) developed recurrence, and 17 cases (10.8%) developed metastasis. The overall 5- and 10-year survival rate was 88.3% and 59.6%, respectively. Age (p = 0.037) and metastasis (p = 0.001) were significant factors influencing survival. The 3-year recurrence free survival rate was 80.1%. The median recurrence free survival time was 69 ± 12.7 months. Tumor level in sacrum (p = 0.035) and surgical margin (p = 0.009) were significant factors influencing recurrence. Seventeen cases (10.8%) had metastasis. Recurrence (p = 0.016) was significant factors influencing metastasis.

CONCLUSIONS: Sacral chordoma tended to occur in elderly male patients and locate below sacral 3 level. The recurrence rate was high, especially for tumor above sacral 3 level. Wide surgical margin is very important for good local control. The patients with metastasis had poor prognosis.