Defining preoperative imaging findings of sacral chordomas associated with decreased overall survival and local recurrence

Sacral chordomas represent the most common primary malignant tumor found in the sacrum (1). Arising from the remnants of the notochord (2), these slow-growing tumors often present with vague symptoms, usually low back pain, in patients in the 5th and 6th decade of life (2,3). The clinical repercussions of the indolent nature of sacral chordomas are two-fold.