Kiss-Bodolay Daniel, Ris Frederic, Lavalley Adrien, Nouri Aria, Oranges Carlo M, Meurette Guillaume, Schaller Karl, Tessitore Enrico, Molliqaj Granit
Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, HUG, 1205 Geneva, Switzerland.
J Clin Med. 2025 Jun 24;14(13):4480. doi: 10.3390/jcm14134480.
: Sacral chordomas are rare, locally invasive tumors that pose significant surgical and oncological challenges due to their anatomical complexity, proximity to critical structures, and resistance to conventional therapies. : A literature search focused on contemporary multidisciplinary management of sacral chordoma was conducted. An illustrative case of such a multidisciplinary approach is presented. : Achieving optimal outcomes necessitates a multidisciplinary approach that balances en-bloc resection with negative margins and preservation of biomechanical stability and neurological function. Negative resection margins are a key determinant of long-term survival and reduced recurrence, particularly for tumors involving the upper sacrum (S1-S2). While postoperative radiation therapy provides adjunctive benefits, precision in surgical planning and execution remains paramount. Emerging technologies, such as augmented reality and 3D-printed anatomical models, are enhancing surgical precision, while the role of multidisciplinary surgical teams in improving outcomes requires further study. : This review highlights the complexities of sacral chordoma management, focusing on surgical strategies, functional trade-offs, and future directions to optimize oncological and functional outcomes.
骶骨脊索瘤是罕见的局部侵袭性肿瘤，由于其解剖结构复杂、靠近关键结构且对传统治疗有抗性，给手术和肿瘤治疗带来了重大挑战。进行了一项聚焦于骶骨脊索瘤当代多学科管理的文献检索，并展示了一个这种多学科方法的实例。要实现最佳治疗效果，需要一种多学科方法，平衡整块切除且切缘阴性与保留生物力学稳定性和神经功能。阴性切除切缘是长期生存和降低复发的关键决定因素，特别是对于累及上骶骨（S1 - S2）的肿瘤。虽然术后放射治疗有辅助益处，但手术规划和执行的精准度仍然至关重要。诸如增强现实和3D打印解剖模型等新兴技术正在提高手术精准度，而多学科手术团队在改善治疗效果方面的作用需要进一步研究。本综述强调了骶骨脊索瘤管理的复杂性，重点关注手术策略、功能权衡以及优化肿瘤学和功能结局的未来方向。
