With an individually tailored surgical approach, total tumor removal in 78% of the cases was achieved at the initial surgery. Radical surgery appears to increase slightly the surgical morbidity, but at the same time prolongs the recurrence-free interval. Chordomas cannot be regarded as surgically curable tumors given the 5- and 10-year survival rates in patients harboring such lesions.

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BACKGROUND. Hepatocyte growth factor (HGF) is a multipotent cytokine that is mediated by its receptor, c‐MET. HGF/c‐MET contributes to tumor progression in many human malignancies; however, HGF/c‐MET is inversely correlated with aggressive biologic behavior in other cancers. Conversely, to the authors' knowledge, little is known regarding the significance of HGF/c‐MET expression in skull base chordoma. METHODS. Using immunohistochemical techniques, the authors investigated HGF/c‐MET expression in 46 primary and 25 recurrent lesions, and compared it with the expression of proteinases and cell differentiation markers, proliferative ability, and other clinicopathologic parameters. RESULTS. c‐MET was found to be expressed in 70.0% of primary and 88.0% of recurrent lesions. HGF expression was scarcely detected. Higher c‐MET expression was found to be correlated with younger patient age. Lesions with a higher expression of low molecular weight cytokeratin (CAM5.2) demonstrated significantly higher c‐MET scores in both primary and recurrent lesions compared with those with lower CAM5.2 expression. In recurrent lesions, higher c‐MET expression was found to be associated with the scores of matrix metalloproteinase (MMP)‐1, MMP‐2, tissue inhibitor of matrix metalloproteinase‐1, and urokinase plasminogen activator (uPA); however, only uPA was found to be correlated with higher c‐MET expression in primary lesions. c‐MET expression did not appear to be correlated with MIB‐1 labeling index. Patients with higher c‐MET expression were found to have longer survival. CONCLUSIONS. In the current study, c‐MET expression was a common event, and was found to be correlated with CAM5.2 expression, younger patient age, and a favorable prognosis in patients with skull base chordoma. However, HGF/c‐MET paracrine signaling also may contribute to its invasive ability, especially in recurrent lesions. Cancer 2008. © 2007 American Cancer Society.