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Arquivos de Medicina
versão On-line ISSN 2183-2447
Resumo
LINHARES, Eduardo et al. Treatment of Sacral Chordomas. Arq Med [online]. 2009, vol.23, n.3, pp.103-107. ISSN 2183-2447.
Introduction: Chordomas are malignant tumors of the spine with origin in the embryonic rests of notochord. Their biological behavior is that of a slow growing tumor but locally aggressive. Extended resections improved significantly the disease free survival in patients with chordoma but may compromise the quality of life permanently. Patients and Method: We performed a retrospective analysis of our experience at the Instituto Nacional do Cancer -Brasil during the period from Jan 1998 to Apr 2008 with sacral chordomas. There were 15 patients for study. We reported pathological and surgical aspects of the cohort with an analysis of survival and performance status (PS). Results: The tumors had a median size of 155 mm (70-300 mm) and 08 patients had only biopsy for diagnosis. In the resected group, there was 01 case of resection at S3/S4 level. All others underwent S1/S2 resections. Excluding 01 case of post-operative death, the overall survival varied from 5 - 60 months (median= 41). The study of PS after surgery showed 02 patients with PS=I; 02 with PS=II and 01 with PS=III. Conclusion: In our opinion surgical resection remains the best therapeutic option. The ideal oncological surgery includes performing a R0 surgery but with good quality of life afterwards. For this goal, we strongly advise a multidisciplinary team.
Palavras-chave : chordoma; therapeutics; surgery.