Prognostic Factors in Surgical Patients with Chordomas of the Cervical Spine: A Study of 52 Cases from a Single Institution

Zhou, Hua; Jiang, Liang; Wei, Feng; Joeris, Alexander; Hurtado-Chong, Anahí; Kalampoki, Vasiliki; Rometsch, Elke; Yu, Miao; Wu, Fan; Dang, Lei; Liu, Xiaoguang; Liu, Zhongjun

doi:10.1245/s10434-017-5884-5

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…Consistent with previous findings, the exposed surgical margin is also a prognostic factor for chordomas. [15] However, sometimes the complete exposure of the tumor is very difficult. Thus, we introduce another technique.…”

Section: Discussionmentioning

confidence: 99%

The clinical outcomes for chordomas in the cranial base and spine

Zhou¹,

Wu³

et al. 2019

Medicine

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Owing to the special growth pattern of chordomas and the limited treatment options currently available, the treatment of chordoma still remains difficult. In this study, we hope to further clarify the relationship between surgical treatment and radiotherapy of chordoma and disease progression. All patients with a primary histopathological diagnosis of clival or spinal chordomas recorded in our institution between 1976 and 2017 were examined. A total of 60 patients (location: skull base/clival, n = 24; vertebral column, n = 5; sacrum, n = 31) had a mean follow-up time of 7.7 years (range 12 months–35 years). Compared with patients who received subtotal resection (n = 5, 5-year and 10-year survival = 61% and 39%, respectively), the annual survival rate of patients who received total resection (n = 55, 5-year and 10-year survival = 67%, respectively) was significantly higher. The overall 10-year survival rate (58%) of patients treated with surgery alone was significantly different from those treated with a combination of surgery and radiation (73%). The long-term prognosis of sacral chordoma was the worst (10-year survival rate = 48%). The best treatment strategy for improved long-term survival in chordoma was a combination of surgical resection and radiation therapy. Adjuvant radiotherapy for chordoma significantly improves disease-free survival, although the long-term survival benefit remains to be determined. A worse prognosis and poor long-term survival are seen in sacral chordomas.

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Section: Discussionmentioning

confidence: 99%

The clinical outcomes for chordomas in the cranial base and spine

Zhou¹,

Wu³

et al. 2019

Medicine

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“…Zhou et al . 25 , a study of 52 cases from a single institution with a mean follow-up of 50 months (median 31 months) and range of 1–228 months, found that contiguous vertebral segment involvement, intralesional surgical margin, lack of treatment with adjuvant radiotherapy, and incisional biopsy significantly increase local recurrence. While tumor location in the upper cervical spine significantly increases tumor-related mortality 25 , the CT-guided fine needle aspiration biopsy and total spondylectomy with marginal excision may improve the survival of patients with cervical chordoma 25 .…”

Section: Discussionmentioning

confidence: 99%

A case report of Sustained triumph: 15-year recurrence-free survival following surgical resection of a cervical chordoma in a 15-year-old girl

Haddad,

Rimawi,

Hussein

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Chordoma of the cervical spine is a rare condition associated with poor long-term outcomes. This is mainly attributed to its pathological involvement of vital structures such as the cervical roots and vertebral artery (VA). Although the most appropriate management in these cases is total en bloc excision, attaining complete resection is relatively challenging due to the vicinity of the critical anatomical structures mentioned above. Case description: A 15-year-old female with middle cervical spine chordoma was treated by a multidisciplinary team involving neurosurgery and head and neck surgeons utilizing anterior and posterior approaches followed by high beam X-ray radiotherapy. Histopathological examination matched the description of a chordoma. Fifteen years after the initial excision, the patient maintained her normal neurological function without local recurrence or metastasis. Clinical discussion: The patient underwent surgery in two stages. A posterior approach for C3, C4 and C5 laminectomies was performed on the first stage with the second stage involving head and neck surgery for complete resection of the tumor. The patient also underwent radiotherapy three months after surgery for a total duration of one month. The patient is currently 30 years old with no evidence of chordoma recurrence. Conclusion: Patients afflicted with cervical chordomas often find themselves undergoing multiple operations due to high recurrence rates. Fortunately, the utilization of en bloc resection coupled with adjuvant radiotherapy presents as a hopeful treatment modality that can serve to substantially reduce recurrence rates, increase survival rates, and ultimately enhance the quality of life.

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“…The central tenet of surgical treatment of chordomas is obtaining wide‐margin, en bloc resection of tumor. It has been demonstrated that subtotal excision of chordomas results in significantly higher rates of local recurrence and shorter intervals of disease‐free survival . Furthermore, it has been shown that violation of tumor margins can result in seeding and recurrence along the surgical pathway .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection is currently the mainstay of therapy, and extent of tumor removal is arguably the most significant prognostic factor . Damage to nearby structures such as brainstem, spinal nerve roots, and blood vessels may preclude en bloc resection of cervical and clival chordomas, resulting in high rates of recurrence.…”

Section: Introductionmentioning

confidence: 99%

Novel approach using transoral robotic surgery for resection of cervical spine chordoma

McCann

Berger

Mahmoud³

et al. 2018

The Laryngoscope

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Chordomas are rare, infiltrative neoplasms of notochordal origin that present along the spinal canal; en bloc surgical resection is paramount to successful treatment. Limited visualization and complex anatomy are major challenges to resection of upper cervical spine chordomas and often require invasive surgery. A 27‐year‐old male presented with an incidentally discovered chordoma of the midline second cervical vertebra of the spine. To obtain en bloc resection of the lesion while both overcoming limitations due to access and without introducing morbidity from traditional anterior approaches, we elected using transoral robotic surgery for resection. Due to complete resection, the patient remains disease‐free and was spared adjuvant radiation. Laryngoscope, 129:1395–1399, 2019

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Prognostic Factors in Surgical Patients with Chordomas of the Cervical Spine: A Study of 52 Cases from a Single Institution

Cited by 7 publications

References 34 publications

The clinical outcomes for chordomas in the cranial base and spine

The clinical outcomes for chordomas in the cranial base and spine

A case report of Sustained triumph: 15-year recurrence-free survival following surgical resection of a cervical chordoma in a 15-year-old girl

Novel approach using transoral robotic surgery for resection of cervical spine chordoma

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