Retrospective cohort study of the characteristics and outcome of surgical treatment of pelvic neurogenic and presacral tumors

Background: Pelvic neurogenic and presacral tumors represent an uncommon, yet a challenging condition. The present study aimed to review the baseline clinicopathologic characteristics and treatment outcome of presacral and sacral neurogenic tumors treated in our institution. Methods: This was a retrospective cohort study of prospectively maintained data of consecutive patients with pelvic neurogenic tumors who underwent surgical treatment at a tertiary referral center between January 2006 and May 2021. Main outcome measures were the demographic characteristics of patients, tumor characteristics, type of surgical treatment, and outcomes, which comprised tumor recurrence and complications. Results: The present study included 43 (55.8% males) patients of a median age of 50 years. The majority of patients had iliac, presacral, or sacral tumors. The most frequent pathology was chordoma (27.9%), schwannoma (27.9%), neuroblastoma (13.9%), and neuroectodermal tumors (13.9%). Overall, 48.8% of tumors were malignant. Fourteen postoperative complications were recorded in 12 patients (27.9%; 95%CI: 15.3-43.7%). After a median follow-up of 30 months, tumor recurrence was recorded in 9 patients (20.9%; 95%CI: 10-36%). The median time to recurrence was 11 months. Patients with recurrence were mostly female and underwent more extensive surgical treatment. Conclusions: Pelvic neurogenic and presacral tumors tend to affect middle-aged individuals with a slight male predominance. Approximately half of pelvic neurogenic tumors are benign with Schwannoma being the most common benign tumor. The mid-term recurrence rate was 20% and female patients were more prone to develop recurrence.