Objective: Sacral tumours are rare pathologies. Their management generates a complex surgical problem, as they usually are diagnosed in advanced stages. The evaluation and complex treatment of these rare tumours require a multidisciplinary approach, optimally at institutions with comprehensive care and experience. The aim of this study is to analyse retrospectively the perspective and outcome after surgical management of sacral tumours over the period of 15 years from our institution.

Materials and Methods:  This is a retrospective study of the patients who underwent sacrectomy between January 2002 and December 2016 in our institution. Patients underwent any of the following three types of sacrectomy: total, subtotal or partial. Sacrectomy was performed by either one of the following approaches: posterior, abdomino–sacral either as sequential or staged approach.  Spino–pelvic reconstruction was not performed in any of the patients.  Patients were analysed for functional outcome (MSTS score) morbidity, and survival (Kaplan Meier method).

Results: Twenty–seven patients underwent sacrectomy of which 12 were partial, 8 were subtotal and 7 were total sacrectomy.  Most common pathology in our study was Giant cell tumour followed by chordoma.  There were fourteen males and thirteen females. 51.8% of patients had bowel and bladder disturbances post operatively 70.3% had wound complications.  Median follow up was 36 months (Range 6–180 months).  Five year OS was 72.1%. Distant metastasis occurred in 1 patient (3.71%). 10 (37.03%) had good outcome and 6 (22.22%) had poor outcome. Staged approach had reduced morbidity.

Conclusion:En bloc resection with adequate margin can achieve long term local oncological control.  Sacrectomy once considered as a morbid procedure, can now be safely performed with improved surgical techniques.  Our experience in sacrectomy with staged approach has shown to achieve lesser perioperative morbidity, better functional outcome and comparable long–term survival.