Şafak GÜNGÖR, Yaman KARAKOÇ, Deniz GÜRLER, Burak ATALAY, Ataç KARAKAŞ, Murat ARIKAN

The Treatment Modalities in Sacral Chordomas

Sakral kordomalar nispeten nadir görülen, lokal invaziv, malign tümörlerdir. Yüksek başarısızlık oranı ve kötü fonksiyonel geri dönüşle karakterizedirler. Kliniğimizde 2000-2006 yılları arasında takip edilen altı sakral kordoma olgusu sunulmuştur. Primer malign bir kemik tümörü olan sakrokoksigeal kordomaların radyoterapi ve kemoterapiye yetersiz yanıtı nedeniyle optimal tedavi olarak komplet eksizyon gereklidir. Kordomaların komplet çıkarılması için uygun cerrahi sınır, tutulan dokulara ve tümörün lokalızasyonuna göre değişmektedir. Tümörün derin dokulara invazyonu sonucu peivik instabilite ve üriner-fekal inkontinans gibi komplikasyonlardan korunmak amacıyla lokal rekürrens ile sonuçlanan inkomplet eksizyon yapılmaktaysa da, biz tedavide komplet rezeksiyon ve lokal rekürrens halinde ise agresif müdahaleyi savunuyoruz.

Anahtar Kelimeler:

Kordoma, sakrokoksigeal.

Sakral Kordomalarda Tedavi Yaklaşımları

Sacral chordomas are relatively rare, locally invasive, maiignant neoplasms. Chordomas is characterized by a high failure rate and a poor fonctional outcome. Six patients were treated for sacral chordoma between 2000-2006 in our clinic. Due to inadequate response to chemo and radiotheraphy, sacrococcygeal chordoma which is a primary malign bone tumour should be excised completely as an optimal therapeutic modality. Complete surgical exploration depends on site of affected tissues and tumour localisation. To prevent these postoperative complications such as pelvic instability, urinary-feacal incontinence, incomplet excision may be a treatment option vvith high local reccurence rate. We advocate an attempt at complete resection and aggressive treatment of local reccurence.

Keywords:

Chordoma, sacrococygeal.,

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