• Yongkun Yang, Xiaohui Niu, Yuan Li, Weifeng Liu, and Hairong Xu.
• Department of Orthopedic Oncology, Beijing Ji Shui Tan Hospital, Peking University, Beijing, People's Republic of China.
• Eur Spine J. 2017 Jul 1; 26 (7): 1910-1916.

PurposeTo evaluate postoperative recurrence, survival and metastasis results and related factors of sacral chordoma.MethodsBetween 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.ResultsThe 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.ConclusionsSacral 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.

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