Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)

Study Design Prospective cohort. Objective The primary objective was to describe bowel and bladder (BB) function by nerve root sacrifice following a Sacrectomy. Secondary objectives were to compare patient reported outcomes (PROs) based on BB function at 12 months, and to assess surgeon–patient reported BB function concordance. Methods Data from AO Spine Knowledge Forum Tumor Primary Tumor Research and Outcomes Network (PTRON) registry included patients who underwent a sacrectomy (S1–S5) for a primary bone tumor, with at least one PRO reported at baseline and 12 months. BB function was recorded at baseline and 12 months. PROs included EQ-5D, SOSGOQv2.0, SF-36, leg/back NRS, ECOG. Results Eighty-one patients were included. Bilateral S1–S2 sacrifice was associated with complete BB dysfunction; preservation of at least one S3 root was associated with preserved BB function in more than half of cases. Distal S4–S5 resections often preserved function, but about one-third had BB dysfunction. Agreement between surgeon–patient reported BB function was moderate (κ 0.39–0.45). At 12 months, patients with preserved BB function reported higher EQ-5D (0.70 vs 0.60, p=0.025) and SOSGOQv2.0 (83.5 vs 67.5, p=0.031), better ECOG (p= 0.028) and lower leg pain (0.5 vs 4.5, p=0.013). Conclusion A substantial proportion of patients experience BB dysfunction after sacrectomy, particularly with more cranial resections. This dysfunction aligned with worse PROs, greater pain, and poorer performance status. Agreement between surgeon- and patient-reported BB outcomes was moderate, emphasizing the importance of incorporating patient-reported measures into follow-up and counseling.

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Journal
Global Spine Journal
Published
2026-11-04
DOI
https://doi.org/10.1177/21925682261505882
Primary Topic
Sarcoma Diagnosis and Treatment
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article
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article

Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)

Taryn Ludwig, Yoga Raja Rampersaud, Michelle J. Clarke, Jorrit‐Jan Verlaan et al.
Global Spine Journal
Sarcoma Diagnosis and Treatment
article

Bowel and Bladder Dysfunction and Patient-Reported Outcomes in Patients Undergoing a Sacrectomy for a Primary Bone Tumor an Observational Study From the Primary Tumor Research and Outcomes Network (PTRON)

Taryn Ludwig, Yoga Raja Rampersaud, Michelle J. Clarke, Jorrit‐Jan Verlaan, Praveen V. Mummaneni, Jeremy Reynolds, Alexander Carl Disch, Áron Lazáry, Ilya Laufer, Laurence D. Rhines, Courtney Rory Goodwin, Ori Barzilai, Daniel G. Tobert, Ziya Levent Gokaslan, Alessandro Gasbarrini, Riccardo Cecchinato, Alessandro Luzzati, Raphaële Charest-Morin, Cordula M. Netzer, Charles G. Fisher, Nicolas Dea, Stefano Boriani
article en

Abstract

Study Design Prospective cohort. Objective The primary objective was to describe bowel and bladder (BB) function by nerve root sacrifice following a Sacrectomy. Secondary objectives were to compare patient reported outcomes (PROs) based on BB function at 12 months, and to assess surgeon–patient reported BB function concordance. Methods Data from AO Spine Knowledge Forum Tumor Primary Tumor Research and Outcomes Network (PTRON) registry included patients who underwent a sacrectomy (S1–S5) for a primary bone tumor, with at least one PRO reported at baseline and 12 months. BB function was recorded at baseline and 12 months. PROs included EQ-5D, SOSGOQv2.0, SF-36, leg/back NRS, ECOG. Results Eighty-one patients were included. Bilateral S1–S2 sacrifice was associated with complete BB dysfunction; preservation of at least one S3 root was associated with preserved BB function in more than half of cases. Distal S4–S5 resections often preserved function, but about one-third had BB dysfunction. Agreement between surgeon–patient reported BB function was moderate (κ 0.39–0.45). At 12 months, patients with preserved BB function reported higher EQ-5D (0.70 vs 0.60, p=0.025) and SOSGOQv2.0 (83.5 vs 67.5, p=0.031), better ECOG (p= 0.028) and lower leg pain (0.5 vs 4.5, p=0.013). Conclusion A substantial proportion of patients experience BB dysfunction after sacrectomy, particularly with more cranial resections. This dysfunction aligned with worse PROs, greater pain, and poorer performance status. Agreement between surgeon- and patient-reported BB outcomes was moderate, emphasizing the importance of incorporating patient-reported measures into follow-up and counseling.

Global Spine Journal
Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), Harvard University (US), University of British Columbia (CA), Duke University (US), University of Toronto (CA), University of Milan (IT), Utrecht University (NL), Brown University (US), Buda Health Center (HU), University Hospital of Basel (CH), University of California System (US), NYU Langone Health (US), IRCCS Ospedale Galeazzi - Sant'Ambrogio (IT), Istituto Ortopedico Rizzoli (IT), University Hospital Carl Gustav Carus (DE), Technische Universität Dresden (DE), University of Bologna (IT)
Openalex Percentile: Top 13%
Sarcoma Diagnosis and Treatment
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