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.	胡建华, 杨曦. 原发性骶骨肿瘤手术治疗19例疗效观察. 山东医药, 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.	贺云飞, 程刚, 石鹏飞. 骶骨肿瘤误诊32例分析. 人民军医, 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.	郭卫, 汤小东, 杨毅, 等. 骶骨肿瘤的分区与手术方法探讨. 中国脊柱脊髓杂志, 2007, 17(8) :605-610.
8.	宋飞, 马庆军, 刘忠军, 等. 原发性骶骨肿瘤的手术治疗. 中国脊柱脊髓杂志, 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.	郭卫, 徐万鹏, 杨荣利, 等. 骶骨肿瘤的手术治疗. 中华外科杂志, 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.	孙馨, 郭卫, 杨荣利, 等. 骶骨肿瘤术后残留骶神经功能的评估. 中国肿瘤临床与康复, 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, 尹文军. 骶骨肿瘤术中4种控制出血方法临床效果评价. 实用肿瘤杂志, 2011, 26(5) :526-529.
19.	陈文华, 王祁, 何忠明, 等. 术前肿瘤动脉栓塞联合术中腹主动脉球囊阻断在骶骨肿瘤切除术中的应用. 介入放射学杂志, 2012, 21(3) :212-215.
20.	单长胜, 于春鹏, 孙成建, 等. 腹主动脉球囊阻断技术在骶骨肿瘤手术治疗中的应用. 国际医学放射学杂志, 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.	张晋煜, 许建波, 袁涛, 等. 手术治疗高位骶骨肿瘤. 临床骨科杂志, 2010, 13(6) :608-610.
28.	丁焕文, 贾军锋, 沈健坚, 等. 计算机辅助下高位骶骨肿瘤的精确切除与缺损部位的重建. 中国骨与关节杂志, 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.	杨永, 马小军, 孙伟, 等. 负压封闭引流技术在原发性骶骨肿瘤后路切口中的应用. 国际骨科学杂志, 2013, 34(5) :375-384.
31.	马焕芝, 曾炳芳. 负压辅助创面关闭技术原理及应用. 国际骨科学杂志, 2011, 32(1) :1-3.
32.	孔金海, 肖辉, 孙正望, 等. 骶骨肿瘤选择性靶血管栓塞后切口并发症的相关性因素分析. 中国骨与关节杂志, 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, Szövérfi 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. 胡建华, 杨曦. 原发性骶骨肿瘤手术治疗19例疗效观察. 山东医药, 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. 贺云飞, 程刚, 石鹏飞. 骶骨肿瘤误诊32例分析. 人民军医, 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. 郭卫, 汤小东, 杨毅, 等. 骶骨肿瘤的分区与手术方法探讨. 中国脊柱脊髓杂志, 2007, 17(8) :605-610.
8. 宋飞, 马庆军, 刘忠军, 等. 原发性骶骨肿瘤的手术治疗. 中国脊柱脊髓杂志, 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. 郭卫, 徐万鹏, 杨荣利, 等. 骶骨肿瘤的手术治疗. 中华外科杂志, 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. 孙馨, 郭卫, 杨荣利, 等. 骶骨肿瘤术后残留骶神经功能的评估. 中国肿瘤临床与康复, 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, 尹文军. 骶骨肿瘤术中4种控制出血方法临床效果评价. 实用肿瘤杂志, 2011, 26(5) :526-529.
19. 陈文华, 王祁, 何忠明, 等. 术前肿瘤动脉栓塞联合术中腹主动脉球囊阻断在骶骨肿瘤切除术中的应用. 介入放射学杂志, 2012, 21(3) :212-215.
20. 单长胜, 于春鹏, 孙成建, 等. 腹主动脉球囊阻断技术在骶骨肿瘤手术治疗中的应用. 国际医学放射学杂志, 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. 张晋煜, 许建波, 袁涛, 等. 手术治疗高位骶骨肿瘤. 临床骨科杂志, 2010, 13(6) :608-610.
28. 丁焕文, 贾军锋, 沈健坚, 等. 计算机辅助下高位骶骨肿瘤的精确切除与缺损部位的重建. 中国骨与关节杂志, 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. 杨永, 马小军, 孙伟, 等. 负压封闭引流技术在原发性骶骨肿瘤后路切口中的应用. 国际骨科学杂志, 2013, 34(5) :375-384.
31. 马焕芝, 曾炳芳. 负压辅助创面关闭技术原理及应用. 国际骨科学杂志, 2011, 32(1) :1-3.
32. 孔金海, 肖辉, 孙正望, 等. 骶骨肿瘤选择性靶血管栓塞后切口并发症的相关性因素分析. 中国骨与关节杂志, 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, Szövérfi 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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