Surgical treatment of sacral XXXX : survival and prognostic factors.

@entity5 @entity1 @entity3580 @entity3
INTRODUCTION: Sacral @entity3580 is a rare low-to-intermediate grade malignant @entity5 . The mainstay of treatment is still surgery with en bloc and wide resection margins, which can grant the best chances of a long-term control or cure of this disease. The first aim of this paper is to collect data about survival, time to local recurrence and @entity3 among @entity1 affected by sacral @entity3580 and primarily treated with surgery. The second aim is to analyze the influence of level resection, @entity5 volume and surgical margins on local recurrence. MATERIALS AND METHODS: The study population was composed of 14 @entity1 treated with sacral @entity3580 resection at the National @entity5 Institute of Naples-Pascale (Italy) from January 2000 to June 2013. The median follow-up was 84  months (range 24-132  months). The follow-up was characterized by: standard radiographs, MRI, and a CT scan of the chest annually. Time to recurrence or @entity3 was calculated from the date of resection to the date of diagnosis of first recurrence or @entity3 . RESULTS: Out of all the @entity1 , six died (42.86  %) during the follow-up; 6 (42.86  %) had local recurrence; 4 (28.57  %) had @entity3 . At univariate analysis wide surgical margins (R0) were associated with increased survival up to a local recurrence (OR  =  0.0286; 95  % CI  =  0.0014-0.5739; P  =  0.026); the level of resection (OR  =  3.33; 95  % CI  =  0.3619-30.7025; P  =  0.592) and @entity5 volume (P  =  1) did not show a statistically significant correlation. DISCUSSION: Based on our experience, we hope all @entity1 to be treated by surgery, the only good standard treatment of this disease. The resection should result in margins as wide as possible. For these reasons, it is essential for this disease to be treated in highly specialized centres because only a complete surgery can offer a chance to care for these @entity1 . CONCLUSIONS: Solid survival at long-term follow-up can be achieved by a surgical resection performed with wide margins.
