High sacrectomy for locally recurrent XXXX : Can long-term survival be achieved?

@entity1 @entity5 @entity260 @entity3 @entity204
BACKGROUND: Locally recurrent @entity5 involving the upper sacrum is generally considered a contra-indication to curative surgery. The aim of this study was to determine if a survival benefit was seen in @entity1 undergoing high sacrectomy. METHODS: All @entity1 with locally recurrent @entity5 involving the sacrum above the 3rd sacral body between 1999 and 2007 were retrospectively reviewed. Kaplan-Meier survival analysis was performed. RESULTS: Nine @entity1 were identified with a median age of 63 years. The proximal extent of sacral resection was through S2 (n   =   6), S1 (n   =   2), and L5-S1 (n   =   1). All @entity1 had R0 negative-margin resection. Median operative time was 13.7   hr, and median operative blood transfusion was 3.7   L. Thirty-day mortality was nil. @entity260 requiring surgical intervention occurred in three @entity1 . Local re-recurrence in the pelvis occurred in one @entity1 . The overall median survival was 31 months (range, 2-39 months). Three @entity1 still alive are free of disease after 40, 76, and 101 months, respectively. Ultimately, all @entity204 were due to @entity3 . CONCLUSIONS: High sacrectomy that achieves clear margins in @entity1 with recurrent @entity5 is safe and feasible. A majority will die of @entity3 , but long-term survival may be possible in some @entity1 .
