Prognosis analysis for the surgical treatment of sacral chondrosarcoma: en-bloc resection versus in?鄄tralesional excision

English Keywords:Chondrosarcoma  Sacral  En bloc resection  Intralesional excision  Survival rate

English Abstract:

  【Abstract】 Objectives: To compare surgical outcome and prognosis of en bloc resection and intralesional excisionfor sacral chondrosarcoma. Methods: 38 patients treated in our hospital from October 1999 to December 2012, including 20 males and 18 females with a mean age of 42.5 years were reviewed retrospectively. Except of 1 patient with mesenchymal chondrosarcoma who abandoned therapy, 37 of 38 patients underwent surgery. En bloc resection and intralesional excision was performed in 12 and 25 patients, respectively. To calculate the incidence of disease-progression of patients who suffered from local recurrence or distant metastasis. The survival and disease-free survival were analyzed by Kaplan-Meier survival curve. The Log-Rank test, chi-square test and independent sample t test were used to compare the influence of different surgery procedures to the prognosis, incidence of postoperative complications and perioperative blood loss, respectively. Results: 34 patients with completed data were enrolled in the research, with an average follow-up time of 29.7 months (4-136 months). 12 patients died(35.3%), 19 patients suffered from local recurrence(58.8%) and 1 patient had lung metastasis(2.94%). The average postoperative overall survival was 87.0±11.3 months. The 1, 2 and 5-year overall survival rate was 82.2%, 68.6% and 59.4%, respectively. The disease-free survival was 48.5±11.8 months. The 1, 2 and 5-year disease-free survival rate was 52.6%, 48.6% and 25.5%, respectively. The incidence of disease-progression in en bloc group and intralesional group was 27.3% and 73.9%, respectively. En bloc resection improved disease-free survival of patients significantly(P<0.05) without elevating incidence of postoperative complications and perioperative blood loss(P＞0.05). Conclusions: En bloc resection is an effective and secure surgical option for sacral chondrosarcoma.