What is the treatment for sacral tumors

Most tumors are clinically divided into benign and malignant types, and sacral tumors are no exception. For example, osteoblastoma, giant cell tumor of bone, and aneurysm, which we often hear about, are benign and can usually be cured quickly after surgical resection. Malignant tumors generally include chordomas, chondrosarcomas, etc. The best treatment for malignant tumors is surgery, because the metastasis rate of sacral malignant tumors is very low, and it is generally not easy for cancer cells to metastasize.

An important issue affecting the quality of life after sacral tumor resection is difficulty in walking and incontinence. Generally speaking, smaller tumors located low down can be easily removed without causing nerve damage. However, large tumors located high up are difficult to remove without causing nerve damage. The function of controlling the sphincter is closely related to the number of nerve roots preserved. If only the S1 nerve roots on both sides are retained during the operation, the function of controlling the sphincter will be lost; if the S2 nerve roots on both sides are retained during the operation, 50% of patients can restore the sphincter function; if one side of the S3 nerve root is retained, most patients can control urination and defecation. Two cases of hemisacrectomy were reported. During the operation, only one sacral nerve root was retained, while the contralateral L5-S5 nerve roots were completely removed along with half of the sacrum. However, postoperative follow-up revealed that both patients had normal bladder and rectal function. Therefore, the principle of nerve root preservation should be: without affecting the more thorough resection of the tumor, preserve the bilateral S1-2 and at least one side of the S3 nerve roots, or one side of the S1-3 nerve roots as much as possible. And cooperate with appropriate functional exercises to maximize the retention of urinary, bowel and sexual functions. At the same time, whether the nerve root is preserved should also take into account the nature of the tumor. When the S1-3 nerve roots are surrounded by high-positioned tumors, these important sacral nerve roots must be preserved for benign tumors; for borderline tumors, these nerve roots should be preserved if radiotherapy can be combined with surgery to kill residual tumor cells; if it is a highly malignant tumor, the tumor can be removed together with the affected nerve roots.

This is a restricted area for surgery. Professor Song Xianwen, a pioneer in bone tumors in China, has boldly begun exploring surgical treatment of sacral tumors, which were considered to be surgical taboos at the time, since the 1970s, based on the actual needs of clinical work and after reading a large amount of domestic and foreign literature. With the accumulation of cases, he has gained a deeper understanding of the pathogenesis of sacral tumors and the biological characteristics of different sacral tumors. The success rate of surgery has gradually increased, complications have gradually decreased, and he has trained a younger generation to continue to carry out in-depth sacral tumor surgery.

API specific biological immunotherapy mainly relies on the patient's own immune cells for tumor treatment. Mononuclear cells are collected from the patient's peripheral blood through biotechnology, and cell separation, induction, proliferation, activation, etc. are carried out in a high-level GMP laboratory to obtain active immune cells, passive immune cells and other immune cells (LAK cells, CD3AK cells, CIK cells, NK cells, NKT cells, TIL cells, DC cells, macrophage γδT cells, TC cells, T cells, etc.) with high activity, quantity and tumor killing ability. According to the patient's condition, the above-mentioned immune cells are organically combined in a personalized manner and then re-infused into the patient's body in multiple times. After the effective combination of multiple immune cells, they promote and influence each other, complement each other's strengths and weaknesses, and perform timely specific memory, recognition and killing of tumor target cells.

The improvement in the diagnosis and treatment of sacral tumors is mainly due to the following factors:

1. Development of imaging technology: clearer digital X-rays, CT, MRI, ECT and other technologies have been widely used in clinical practice

2. Improvement of pathological diagnosis technology: including improvement of preoperative biopsy technology and use of new pathological technologies

3. Application of preoperative assessment system

4. Application of vascular embolization technology

5. Application of various internal fixation materials

6. Application of API-specific biological immunotherapy

The use of various new internal fixation materials provides an opportunity to reconstruct spinal stability after total sacral tumor resection, but maintaining spinal stability is based on the premise that the tumor does not recur.