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Bone Sarcomas

(P 95) LONG-TERM OUTCOMES OF PATIENTS DIAGNOSED WITH CHORDOMA OF THE SACRUM

Location: The Liffey, Level 1

    Author(s)

  • AB

    Aneta Borkowska, MD PhD

    Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology
    Warsaw, Mazowieckie, Poland

    • Co-Author(s)

  • AP

    Andrzej Pienkowski, MD, Phd

    Maria Sklodowska-Curie National Research Institute of Oncology
    Warsaw, Mazowieckie, Poland

  • Piotr L. Rutkowski, MD, PhD

    Head of Department of Soft Tissue/Bone Sarcoma and Melanoma
    Maria Sklodowska-Curie National Research Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw Poland
    Warsaw, Mazowieckie, Poland

Objective: Oligoprogression is a limited progression after a prior response to treatment. Oligoprogression remains a major clinical challenge in patients with metastatic melanoma (MM). Local therapy for progressing metastases may enable the continuation of effective systemic therapy.

Methods: We identified 48 patients with chordoma of the sacrum diagnosis in a tertiary center between 2005 and 2020. We assessed patients’ characteristics, progression free survival (PFS), and overall survival (OS) comparing surgery and RTH. The data cut-off was 10/Mar/2023.

Results: Majority of the group consists of men (58%). Twenty-nine of patients (60%) underwent initial surgery, with adjuvant RTH in 7 cases of inadequate resection. Rest of patients underwent RTH as primary treatment. The 3- and 5-year PFS rates in the whole group were 59% and 41%, respectively. The 3- and 5-year PFS rates were numerically better in the surgery group, 65% and 46%, respectively, compared to 3- and 5-year PSF results 50% and 32%, respectively in the RTH group (Fig. 1). Although, there was no statistical significance (p=0.59).
The 3- and 5-year OS rates in the whole group were 92% and 65%, respectively. Survival rates in a group with initial surgery were significantly better compared to RTH (p=0.01, Fig. 2). The 3- and 5-year OS in the surgery group were 96%, and 76%, respectively, compared to the group of primary RTH with 89% 3-year OS, and 51% 5-year OS. The median size of lesions in the RTH group were bigger compared to the surgery group, 12cm versus 9cm, respectively. Nevertheless, there were no significant differences in survival (p=0.098, Fig. 3) nor local progression (p=0.5) between lesion size of < 10cm versus >=10cm. Interestingly, addiction of RTH in cases of recurrence after primary surgery did not improve survival outcomes (p=0.83). Also, the administration of salvage surgery after recurrence in the group of primary surgery was also not associated with improved survival outcomes (p=0.32).

Conclusion: En-bloc excision with broad margins stays the gold standard of sacral chordoma treatment. Radiotherapy can be useful in non-operative cases. The role of RTH as adjuvant after surgery with inadequate margins remains unclear.