Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study

Background Chordoma is a rare and aggressive primary bone sarcoma. En-block resection remains the primary treatment, but some patients are unable to undergo it due to the location and potential complications. Currently, there is no direct comparison of the effects of radiotherapy (RTH) and surgical...

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Main Authors: Aneta Maria Borkowska PhD, Andrzej Pieńkowski MD, Paulina Chmiel MD, Tomasz Skóra MD, Radosław Michalik PhD, Piotr Rutkowski Prof., Mateusz Jacek Spałek PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Cancer Control
Online Access:https://doi.org/10.1177/10732748251323730
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author Aneta Maria Borkowska PhD
Andrzej Pieńkowski MD
Paulina Chmiel MD
Tomasz Skóra MD
Radosław Michalik PhD
Piotr Rutkowski Prof.
Mateusz Jacek Spałek PhD
author_facet Aneta Maria Borkowska PhD
Andrzej Pieńkowski MD
Paulina Chmiel MD
Tomasz Skóra MD
Radosław Michalik PhD
Piotr Rutkowski Prof.
Mateusz Jacek Spałek PhD
author_sort Aneta Maria Borkowska PhD
collection DOAJ
description Background Chordoma is a rare and aggressive primary bone sarcoma. En-block resection remains the primary treatment, but some patients are unable to undergo it due to the location and potential complications. Currently, there is no direct comparison of the effects of radiotherapy (RTH) and surgical treatment. However, retrospective analyses indicate the potential benefits of using RTH. Methods A retrospective analysis was conducted on 48 patients with sacral chordoma who were treated with surgery and/or radiotherapy between 2001-2020. Among those, 22 were initially treated with surgery, 19 with definitive radiotherapy, and 7 received combined treatment. The outcomes of the treatment of recurrence in 16 patients were considered. The resection margins were defined according to R classification, and the Kaplan-Meier method was employed to calculate disease-free survival (DFS) and overall survival (OS). Results The median (mOS) for the entire cohort was 80.6 months (95% CI: 62.3-NA), and the median (mDFS) was 40.4 months (95% CI: 35-69.5). Patients who underwent radical surgery of the primary tumor did not achieve the mOS (mean 68), while patients treated only with RTH for the primary tumor achieved an mOS of 62.3 months (95% CI: 52.1-NA). This resulted in a significant advantage of surgery over RTH in terms of OS ( P = 0.01). This was not observed for DFS. The 3-year DFS rates were 65% in the surgical treatment group and 53.3% in the RTH group. The 3-year OS rates were 96% in the surgery group and 88.9% in the RTH group. In the treatment of recurrence, there were no statistically significant differences between RTH and surgery, for OS ( P = 0.76). Conclusions Radical surgery remains the optimal treatment for sacral chordoma. For patients who are not candidates for surgical intervention, RTH offers excellent long-term outcomes. The treatment of recurrence remains a significant challenge. Comparing modern RTH techniques and surgical procedures could provide further insights.
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spelling doaj-art-3d686bb3ee474986b02268f916ea6a6c2025-08-20T01:57:55ZengSAGE PublishingCancer Control1526-23592025-02-013210.1177/10732748251323730Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter StudyAneta Maria Borkowska PhDAndrzej Pieńkowski MDPaulina Chmiel MDTomasz Skóra MDRadosław Michalik PhDPiotr Rutkowski Prof.Mateusz Jacek Spałek PhDBackground Chordoma is a rare and aggressive primary bone sarcoma. En-block resection remains the primary treatment, but some patients are unable to undergo it due to the location and potential complications. Currently, there is no direct comparison of the effects of radiotherapy (RTH) and surgical treatment. However, retrospective analyses indicate the potential benefits of using RTH. Methods A retrospective analysis was conducted on 48 patients with sacral chordoma who were treated with surgery and/or radiotherapy between 2001-2020. Among those, 22 were initially treated with surgery, 19 with definitive radiotherapy, and 7 received combined treatment. The outcomes of the treatment of recurrence in 16 patients were considered. The resection margins were defined according to R classification, and the Kaplan-Meier method was employed to calculate disease-free survival (DFS) and overall survival (OS). Results The median (mOS) for the entire cohort was 80.6 months (95% CI: 62.3-NA), and the median (mDFS) was 40.4 months (95% CI: 35-69.5). Patients who underwent radical surgery of the primary tumor did not achieve the mOS (mean 68), while patients treated only with RTH for the primary tumor achieved an mOS of 62.3 months (95% CI: 52.1-NA). This resulted in a significant advantage of surgery over RTH in terms of OS ( P = 0.01). This was not observed for DFS. The 3-year DFS rates were 65% in the surgical treatment group and 53.3% in the RTH group. The 3-year OS rates were 96% in the surgery group and 88.9% in the RTH group. In the treatment of recurrence, there were no statistically significant differences between RTH and surgery, for OS ( P = 0.76). Conclusions Radical surgery remains the optimal treatment for sacral chordoma. For patients who are not candidates for surgical intervention, RTH offers excellent long-term outcomes. The treatment of recurrence remains a significant challenge. Comparing modern RTH techniques and surgical procedures could provide further insights.https://doi.org/10.1177/10732748251323730
spellingShingle Aneta Maria Borkowska PhD
Andrzej Pieńkowski MD
Paulina Chmiel MD
Tomasz Skóra MD
Radosław Michalik PhD
Piotr Rutkowski Prof.
Mateusz Jacek Spałek PhD
Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
Cancer Control
title Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
title_full Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
title_fullStr Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
title_full_unstemmed Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
title_short Long-Term Outcomes of Patients Diagnosed With Sacral Chordoma in a Retrospective Multicenter Study
title_sort long term outcomes of patients diagnosed with sacral chordoma in a retrospective multicenter study
url https://doi.org/10.1177/10732748251323730
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