ADVANCE IN SURGICAL TREATMENT OF PRIMARY SACRUM TUMOR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZANGLeyuan ,  CHUTongwei

Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, P. R. China;

Corresponding?author：

CHUTongwei, Email: chtw@sina.com

Keywords：

Primary sacrum tumor; Surgical treatment; Sacrum tumor resection; Pelvic reconstruction

DOI：

10.7507/1002-1892.20160103

Video：

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Objective To summarize the research progress of surgical treatment for primary sacrum tumor. Method The domestic and foreign related literature about surgical treatment of primary sacrum tumor, and many aspects of its surgical procedures, intraoperative hemostasis, pelvic reconstruction, protection of sacral nerve, complications, and prognosis was summarized and analyzed. Results The operation is the major therapy for primary sacrum tumor. However, surgical procedures, protection of sacral nerve, and the way of intraoperative hemostasis remain controversial. Meanwhile, the complexity of pelvic reconstruction, the diversity of complications, and prognosis related with many factors bring difficulties and challenges to the surgical treatment. Conclusions It is urgent need to develop an effective unified standard to conduct diagnosis and treatment of primary sacrum tumor.

Citation： ZANGLeyuan, CHUTongwei. ADVANCE IN SURGICAL TREATMENT OF PRIMARY SACRUM TUMOR. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 518-522. doi: 10.7507/1002-1892.20160103 Copy

1.	胡建華, 楊曦. 原發性骶骨腫瘤手術治療19例療效觀察. 山東醫藥, 2012, 52(33) :96-97.
2.	Sung HW, Shu WP, Wang HM, et al. Surgical treatment of primary tumors of the sacrum. Clin Orthop Relat Res, 1987, (215) :91-98.
3.	賀云飛, 程剛, 石鵬飛. 骶骨腫瘤誤診32例分析. 人民軍醫, 2012, 55(7) :664-665.
4.	McLoughlin GS, Sciubba DM, Suk I, et al. En bloc total sacrectomy performed in a single stage through a posterior approach. Neurosurgery, 2008, 63(1 Suppl 1) :ONS115-120.
5.	Enneking WF, Spanier SS, Goodman MA. A system for thesurgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res, 1980, (153) :106-120.
6.	Boriani S, Biagini R, De Iure F, et al. En bloc resections of bone tumors of thethoracolumbar spine. A preliminary report on 29 patients. Spine (Phila Pa 1976) , 1996, 21(16) :1927-1931.
7.	郭衛, 湯小東, 楊毅, 等. 骶骨腫瘤的分區與手術方法探討. 中國脊柱脊髓雜志, 2007, 17(8) :605-610.
8.	宋飛, 馬慶軍, 劉忠軍, 等. 原發性骶骨腫瘤的手術治療. 中國脊柱脊髓雜志, 2010, 20(8) :629-634.
9.	Dubory A, Missenard G, Lambert B, et al. Interest of laparoscopy for "En bloc" resection of primary malignant sacral tumors by combined approach. Comparative study with open median laparotomy. Spine (Phila Pa 1976) , 2015, 40(19) :1542-1552.
10.	Schwab JH, Healey JH, Rose P, et al. The surgical management of sacral chordomas. Spine (Phila Pa 1976) , 2009, 34(24) :2700-2704.
11.	郭衛, 徐萬鵬, 楊榮利, 等. 骶骨腫瘤的手術治療. 中華外科雜志, 2003, 41(11) :827-831.
12.	Li D, Guo W, Tang X, et al. Preservation of the contralateral sacral nerves during hemisacrectomy for sacral malignancies. Eur Spine J, 2014, 23(9) :1933-1939.
13.	Huth JF, Dawson EG, Eilber FR. Abdominosacral resection for malignant tumors of the sacrum. Am J Surg, 1984, 148(1) :157-161.
14.	孫馨, 郭衛, 楊榮利, 等. 骶骨腫瘤術后殘留骶神經功能的評估. 中國腫瘤臨床與康復, 2010, 17(2) :111-114.
15.	Fourney DR, Rhines LD, Hentschel SJ, et al. En bloc resection of primary sacral tumors:classification of surgicalapproaches and outcome. J Neurosurg Spine, 2005, 3(2) :111-122.
16.	Osaka S, Kondoh O, Yoshida Y, et al. Radical excision of malignant sacral tumors using a modified threadwire saw. J Surg Oncol, 2006, 93(4) :312-317.
17.	Tang X, Guo W, Yang R, et al. Risk factors for blood loss during sacral tumor resection. Clin Orthop Relat Res, 2009, 467(6) :1599-1604.
18.	李世德, 尹文軍. 骶骨腫瘤術中4種控制出血方法臨床效果評價. 實用腫瘤雜志, 2011, 26(5) :526-529.
19.	陳文華, 王祁, 何忠明, 等. 術前腫瘤動脈栓塞聯合術中腹主動脈球囊阻斷在骶骨腫瘤切除術中的應用. 介入放射學雜志, 2012, 21(3) :212-215.
20.	單長勝, 于春鵬, 孫成建, 等. 腹主動脈球囊阻斷技術在骶骨腫瘤手術治療中的應用. 國際醫學放射學雜志, 2015, 38(2) :107-109, 114.
21.	Yang L, Chong QT, Hai BS, et al. Appling the abdominal aortic-balloon occluding combine with blood pressure sensor of dorsal artery of foot to control bleeding during the pelvic and sacrum tumors surgery. J Surg Oncol, 2008, 97(7) :626-628.
22.	Gunterberg B, Romanus B, Stener B. Pelvic strength after major amputation of the sacrum:an experimental study. Acta Orthop Scand, 1976, 47(6) :635-642.
23.	Mindea SA, Salehi SA, Ganju A, et al. Lumbosacropelvic junction reconstruction resulting in early ambulation for patients with lumbosacral neoplasms or osteomyelitis. Neurosurg Focus, 2003, 15(2) :E6.
24.	Leggon RE, Zlotecki R, Reith J, et al. Giant cell tumor of the pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res, 2004, (423) :196-207.
25.	Varga PP, Bors I, Lazary A. Sacral tumors and management. Orthop Clin North Am, 2009, 40(1) :105-123, vii.
26.	Chang DW, Friel MT, Youssef AA. Reconstructive strategiesin soft tissue reconstruction after resection of spinal neoplasms. Spine (Phila Pa 1976) , 2007, 32(10) :1101-1106.
27.	張晉煜, 許建波, 袁濤, 等. 手術治療高位骶骨腫瘤. 臨床骨科雜志, 2010, 13(6) :608-610.
28.	丁煥文, 賈軍鋒, 沈健堅, 等. 計算機輔助下高位骶骨腫瘤的精確切除與缺損部位的重建. 中國骨與關節雜志, 2013, 2(9) :484-489.
29.	Chen KW, Yang HL, Lu J, et al. Risk factors for postoperative wound infections of sacral chordoma after surgical excision. J Spinal Disord Tech, 2011, 24(4) :230-234.
30.	楊永, 馬小軍, 孫偉, 等. 負壓封閉引流技術在原發性骶骨腫瘤后路切口中的應用. 國際骨科學雜志, 2013, 34(5) :375-384.
31.	馬煥芝, 曾炳芳. 負壓輔助創面關閉技術原理及應用. 國際骨科學雜志, 2011, 32(1) :1-3.
32.	孔金海, 肖輝, 孫正望, 等. 骶骨腫瘤選擇性靶血管栓塞后切口并發癥的相關性因素分析. 中國骨與關節雜志, 2015, 4(10) :795-798.
33.	Ruggieri P, Mavrogenis AF, Ussia G, et al. Recurrence after and complications associated with adjuvant treatments for sacral giant cell tumor. Clin Orthop Relat Res, 2010, 468(11) :2954-2961.
34.	Angelini A, Pala E, Calabrò T, et al. Prognostic Factors in Surgical Resection of Sacral Chordoma. J Surg Oncol, 2015, 112(4) :344-351.
35.	Hulen CA, Temple HT, Fox WP, et al. Oncologic and functional outcome following sacrectomy for sacral chordoma. J Bone Joint Surg (Am), 2006, 88(7) :1532-1539.
36.	Bergh P, Kindblom LG, Gunterberg B, et al. Prognostic factors in chordoma of the sacrum and mobile spine:a study of 39 patients. Cancer, 2000, 88(9) :2122-2134.
37.	Osaka S, Kodoh O, Sugita H, et al. Clinical significance of a wide excision policy for sacrococcygeal chordoma. J Cancer Res Clin Oncol, 2006, 132(4) :213-218.
38.	Boriani S, Bandiera S, Biagini R, et al. Chordoma of the mobile spine:fifty years of experience. Spine (Phila Pa 1976) , 2006, 31(4) :493-503.
39.	Eriksson B, Gunterberg B, Kindblom LG. Chordoma:a clinicopathologic and prognostic study of a Swedish national series. Acta Orthop Scand, 1981, 52(1) :49-58.
40.	Soo MY. Chordoma:review of clinicoradiological features and factors affecting survival. Australas Radiol, 2001, 45(4) :427-434.
41.	Ozger H, Eralp L, Sungur M, et al. Surgical management of sacral chordoma. Acta Orthop Belg, 2010, 76(2) :243-253.
42.	Varga PP, Sz?vérfi Z, Fisher CG, et al. Surgical treatment of sacral chordoma:prognostic variables for local recurrence and overall survival. Eur Spine J, 2015, 24(5) :1092-1101.
43.	Li G, Fu D, Chen K, et al. Surgicalstrategy for the management of sacral giant cell tumors:a 32-case series. Spine J, 2012, 12(6) :484-491.
44.	Imai R, Kamada T, Tsuji H, et al. Carbonion radiotherapy for unresectable sacral chordomas. Clin Cancer Res, 2004, 10(17) :5741-5746.
45.	Casali PG, Stacchiotti S, Sangalli C, et al. Chordoma. Curr Opin Oncol, 2007, 19(4) :367-370.
46.	Hof H, Welzel T, Debus J. Effectiveness of cetuxiab/gefitinib in the therapy of a sacral chordoma. Onkologie, 2006, 29(12) :572-574.

1. 胡建華, 楊曦. 原發性骶骨腫瘤手術治療19例療效觀察. 山東醫藥, 2012, 52(33) :96-97.
2. Sung HW, Shu WP, Wang HM, et al. Surgical treatment of primary tumors of the sacrum. Clin Orthop Relat Res, 1987, (215) :91-98.
3. 賀云飛, 程剛, 石鵬飛. 骶骨腫瘤誤診32例分析. 人民軍醫, 2012, 55(7) :664-665.
4. McLoughlin GS, Sciubba DM, Suk I, et al. En bloc total sacrectomy performed in a single stage through a posterior approach. Neurosurgery, 2008, 63(1 Suppl 1) :ONS115-120.
5. Enneking WF, Spanier SS, Goodman MA. A system for thesurgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res, 1980, (153) :106-120.
6. Boriani S, Biagini R, De Iure F, et al. En bloc resections of bone tumors of thethoracolumbar spine. A preliminary report on 29 patients. Spine (Phila Pa 1976) , 1996, 21(16) :1927-1931.
7. 郭衛, 湯小東, 楊毅, 等. 骶骨腫瘤的分區與手術方法探討. 中國脊柱脊髓雜志, 2007, 17(8) :605-610.
8. 宋飛, 馬慶軍, 劉忠軍, 等. 原發性骶骨腫瘤的手術治療. 中國脊柱脊髓雜志, 2010, 20(8) :629-634.
9. Dubory A, Missenard G, Lambert B, et al. Interest of laparoscopy for "En bloc" resection of primary malignant sacral tumors by combined approach. Comparative study with open median laparotomy. Spine (Phila Pa 1976) , 2015, 40(19) :1542-1552.
10. Schwab JH, Healey JH, Rose P, et al. The surgical management of sacral chordomas. Spine (Phila Pa 1976) , 2009, 34(24) :2700-2704.
11. 郭衛, 徐萬鵬, 楊榮利, 等. 骶骨腫瘤的手術治療. 中華外科雜志, 2003, 41(11) :827-831.
12. Li D, Guo W, Tang X, et al. Preservation of the contralateral sacral nerves during hemisacrectomy for sacral malignancies. Eur Spine J, 2014, 23(9) :1933-1939.
13. Huth JF, Dawson EG, Eilber FR. Abdominosacral resection for malignant tumors of the sacrum. Am J Surg, 1984, 148(1) :157-161.
14. 孫馨, 郭衛, 楊榮利, 等. 骶骨腫瘤術后殘留骶神經功能的評估. 中國腫瘤臨床與康復, 2010, 17(2) :111-114.
15. Fourney DR, Rhines LD, Hentschel SJ, et al. En bloc resection of primary sacral tumors:classification of surgicalapproaches and outcome. J Neurosurg Spine, 2005, 3(2) :111-122.
16. Osaka S, Kondoh O, Yoshida Y, et al. Radical excision of malignant sacral tumors using a modified threadwire saw. J Surg Oncol, 2006, 93(4) :312-317.
17. Tang X, Guo W, Yang R, et al. Risk factors for blood loss during sacral tumor resection. Clin Orthop Relat Res, 2009, 467(6) :1599-1604.
18. 李世德, 尹文軍. 骶骨腫瘤術中4種控制出血方法臨床效果評價. 實用腫瘤雜志, 2011, 26(5) :526-529.
19. 陳文華, 王祁, 何忠明, 等. 術前腫瘤動脈栓塞聯合術中腹主動脈球囊阻斷在骶骨腫瘤切除術中的應用. 介入放射學雜志, 2012, 21(3) :212-215.
20. 單長勝, 于春鵬, 孫成建, 等. 腹主動脈球囊阻斷技術在骶骨腫瘤手術治療中的應用. 國際醫學放射學雜志, 2015, 38(2) :107-109, 114.
21. Yang L, Chong QT, Hai BS, et al. Appling the abdominal aortic-balloon occluding combine with blood pressure sensor of dorsal artery of foot to control bleeding during the pelvic and sacrum tumors surgery. J Surg Oncol, 2008, 97(7) :626-628.
22. Gunterberg B, Romanus B, Stener B. Pelvic strength after major amputation of the sacrum:an experimental study. Acta Orthop Scand, 1976, 47(6) :635-642.
23. Mindea SA, Salehi SA, Ganju A, et al. Lumbosacropelvic junction reconstruction resulting in early ambulation for patients with lumbosacral neoplasms or osteomyelitis. Neurosurg Focus, 2003, 15(2) :E6.
24. Leggon RE, Zlotecki R, Reith J, et al. Giant cell tumor of the pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res, 2004, (423) :196-207.
25. Varga PP, Bors I, Lazary A. Sacral tumors and management. Orthop Clin North Am, 2009, 40(1) :105-123, vii.
26. Chang DW, Friel MT, Youssef AA. Reconstructive strategiesin soft tissue reconstruction after resection of spinal neoplasms. Spine (Phila Pa 1976) , 2007, 32(10) :1101-1106.
27. 張晉煜, 許建波, 袁濤, 等. 手術治療高位骶骨腫瘤. 臨床骨科雜志, 2010, 13(6) :608-610.
28. 丁煥文, 賈軍鋒, 沈健堅, 等. 計算機輔助下高位骶骨腫瘤的精確切除與缺損部位的重建. 中國骨與關節雜志, 2013, 2(9) :484-489.
29. Chen KW, Yang HL, Lu J, et al. Risk factors for postoperative wound infections of sacral chordoma after surgical excision. J Spinal Disord Tech, 2011, 24(4) :230-234.
30. 楊永, 馬小軍, 孫偉, 等. 負壓封閉引流技術在原發性骶骨腫瘤后路切口中的應用. 國際骨科學雜志, 2013, 34(5) :375-384.
31. 馬煥芝, 曾炳芳. 負壓輔助創面關閉技術原理及應用. 國際骨科學雜志, 2011, 32(1) :1-3.
32. 孔金海, 肖輝, 孫正望, 等. 骶骨腫瘤選擇性靶血管栓塞后切口并發癥的相關性因素分析. 中國骨與關節雜志, 2015, 4(10) :795-798.
33. Ruggieri P, Mavrogenis AF, Ussia G, et al. Recurrence after and complications associated with adjuvant treatments for sacral giant cell tumor. Clin Orthop Relat Res, 2010, 468(11) :2954-2961.
34. Angelini A, Pala E, Calabrò T, et al. Prognostic Factors in Surgical Resection of Sacral Chordoma. J Surg Oncol, 2015, 112(4) :344-351.
35. Hulen CA, Temple HT, Fox WP, et al. Oncologic and functional outcome following sacrectomy for sacral chordoma. J Bone Joint Surg (Am), 2006, 88(7) :1532-1539.
36. Bergh P, Kindblom LG, Gunterberg B, et al. Prognostic factors in chordoma of the sacrum and mobile spine:a study of 39 patients. Cancer, 2000, 88(9) :2122-2134.
37. Osaka S, Kodoh O, Sugita H, et al. Clinical significance of a wide excision policy for sacrococcygeal chordoma. J Cancer Res Clin Oncol, 2006, 132(4) :213-218.
38. Boriani S, Bandiera S, Biagini R, et al. Chordoma of the mobile spine:fifty years of experience. Spine (Phila Pa 1976) , 2006, 31(4) :493-503.
39. Eriksson B, Gunterberg B, Kindblom LG. Chordoma:a clinicopathologic and prognostic study of a Swedish national series. Acta Orthop Scand, 1981, 52(1) :49-58.
40. Soo MY. Chordoma:review of clinicoradiological features and factors affecting survival. Australas Radiol, 2001, 45(4) :427-434.
41. Ozger H, Eralp L, Sungur M, et al. Surgical management of sacral chordoma. Acta Orthop Belg, 2010, 76(2) :243-253.
42. Varga PP, Sz?vérfi Z, Fisher CG, et al. Surgical treatment of sacral chordoma:prognostic variables for local recurrence and overall survival. Eur Spine J, 2015, 24(5) :1092-1101.
43. Li G, Fu D, Chen K, et al. Surgicalstrategy for the management of sacral giant cell tumors:a 32-case series. Spine J, 2012, 12(6) :484-491.
44. Imai R, Kamada T, Tsuji H, et al. Carbonion radiotherapy for unresectable sacral chordomas. Clin Cancer Res, 2004, 10(17) :5741-5746.
45. Casali PG, Stacchiotti S, Sangalli C, et al. Chordoma. Curr Opin Oncol, 2007, 19(4) :367-370.
46. Hof H, Welzel T, Debus J. Effectiveness of cetuxiab/gefitinib in the therapy of a sacral chordoma. Onkologie, 2006, 29(12) :572-574.

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ADVANCE IN SURGICAL TREATMENT OF PRIMARY SACRUM TUMOR

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