Prognostic factors in surgical resection of sacral XXXX .

@entity5 @entity1 @entity3580 @entity8950
BACKGROUND AND OBJECTIVES: The best treatment of sacral @entity3580 is surgical resection, nowadays associated with optimized radiation therapy. We analysed 1) the oncologic outcome in a large series; 2) the effect of previous intralesional surgery, resection level, @entity5 volume and margins on survivorship to @entity8950 ) the complication rate. METHODS: We reviewed 71 @entity1 with sacral @entity3580 . Forty-eight resections were proximal to S3. Mean @entity5 volume was 535 cm3. Eleven received previous intralesional surgery elsewhere. Margins were wide in 44 resections, wide-contaminated in 11, marginal in 9 and intralesional in 7. RESULTS: Overall survival was 92%, 65% and 44% at 5, 10 and 15 years. At a mean of 9.5 years 37 were NED (54.4%), 23 died with disease (33.8%) and 8 were alive with disease (11.7%). Relapses included 15 LRs, 6 distant metastases, 17 both. LR rate was significantly higher in @entity1 with previous surgery (p=0.0217), with inadequate margins (p= 0.0339) and large @entity5 (p<0.01), whereas resection level was not significant. Multivariate analysis confirmed the role of @entity5 volume. Complication rate was high (80.9%) with an infection rate of 41.2%. CONCLUSIONS: The most prominent adverse factor for LR was previous intralesional surgery. LR rate was related with inadequate margins and @entity5 volume. J. Surg. Oncol. 2015; 112:344-351.    2015 Wiley Periodicals, Inc.
