Base of skull chordoma. A correlative study of histologic and clinical features of 62 cases

O'Connell, X M B John; Rosenberg, Andrew E.; Renard, Laurette; Liebsch, Norbert J.; Efird, Jimmy T.; Munzenrider, John E.

doi:10.1002/1097-0142(19941015)74:8<2261::aid-cncr2820740809>3.0.co;2-0

Cited by 164 publications

(101 citation statements)

References 21 publications

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“…We observed a 7:2 ratio in favor of males. Although sex is not thought to be of prognostic value in chordomas, it has been suggested that female sex is an independent predictor of shortened survival in skull base chordomas (20). We in our series did not notice such a finding.…”

Section: Histopathological/cytological Characteristicscontrasting

confidence: 76%

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Clinicopathological characteristics of chordoma - an institutional experience and a review of literature

Makhdoomi

Ramzan²,

Nayil³

et al. 2012

Turkish Neurosurgery

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AIm: To study the clinicopathologic characteristics of chordomas from a single institution. results:The overall mean age of the patients was 46.72 years. Males outnumbered females. Sacrum was the commonest site involved. Histopathologically, the majority of cases were conventional chordoma with four cases of chondroid variety. There was a single case of dedifferentiated chordoma that presented with bone metastasis. Most patients did well after surgery and radiotherapy. One patient had a local recurrence and one patient with dedifferentiated variant died on follow-up. BulGulAr: Hastaların ortalama yaşı 46,72 yıldı. Erkeklerin sayısı kadınlardan fazlaydı. En sık tutulan bölge sakrumdu. Histopatolojik olarak olguların çoğu konvansiyonel kordomayken kondroid tipte dört olgu vardı. Kemik metastazıyla gelen tek bir dediferansiye kordoma olgusu görüldü. Çoğu hasta cerrahi ve radyoterapiye iyi sonuç verdi. Bir hastada yerel nüks oldu ve dediferansiye varyantın bulunduğu bir hasta da takip sırasında öldü. sOnuÇ: Lokal olarak agresif olmalarına rağmen kordomalar rejeksiyon ve postoperatif radyoterapiyle etkin bir şekilde tedavi edilebilir.

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Section: Histopathological/cytological Characteristicscontrasting

confidence: 76%

“…Tumors of the clivus are best managed by subtotal decompression and radiotherapy. These present a major challenge to the neurosurgeon because gross total removal of the tumor with preservation of neural and vascular structures is difficult (20). High cervical tumors can be managed by trans-oral decompression and posterior stabilization of the spine (2).…”

mentioning

confidence: 99%

Clinicopathological characteristics of chordoma - an institutional experience and a review of literature

Makhdoomi

Ramzan²,

Nayil³

et al. 2012

Turkish Neurosurgery

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“…10 However, O'Connell et al 11 reported that female sex was an independent predictors of shorter survival (P ¼ 0.004) for skull base chordoma. The same observation was reported by Thieblemont et al 12 in a series of 26 patients with chordoma.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of sacral chordoma after surgical therapy: a study of 36 patients

et al. 2009

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Study design: Retrospective study. Objectives: To investigate prognostic factors of sacral chordomas and provide theoretical foundation for an improvement of continuous disease-free survival (CDFS). Methods: Thirty-six patients underwent initial operation for sacral chordoma between 1992 and 2007. Data regarding age, gender, tumor size, tumor location, and type of surgery, surgical margins, surrounding muscle invasion, radiation therapy, and recurrences were reviewed and analyzed statistically. Results: The average duration of follow-up was 74.4 months (range, 16-182 months). Sixteen patients developed local recurrences at the time of final follow-up. The average recurrence time was 30 months (range, 3-84 months). The 5-year and 10-year actuarial CDFS were 59.5 and 42%, respectively. CDFS was found statistically longer in patients whose tumor highest level at or below S3 compared with above S3 (P ¼ 0.047). Patients who had invasion into the surrounding muscle had a shorter CDFS than those without surrounding muscle invasion (P ¼ 0.014). Statistic analysis showed that the type of surgery was the most valuable indicator of CDFS (P ¼ 0.001). The local recurrence rate was statistically higher when an inadequate margin has been achieved (P ¼ 0.021). The Cox multivariate regression analysis showed that surrounding muscle invasion (P ¼ 0.024) was an independent adverse prognostic factor for CDFS, whereas incomplete excision (P ¼ 0.056) achieved borderline significance. Conclusions: The higher level of tumor involvement, invasion into the surrounding muscle, incomplete excision, and inadequate surgical margins are poor prognostic factors. Resecting the tumor completely with wide surgical margins may provide a better prognosis for these patients.

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“…Tumor size and radiation dose appear to be inverse and direct, respectively, predictors of tumor control. 5,43,72,95 Other factors such as sex (female sex being associated with a poorer prognosis), 5,40,72 involvement of dose-limiting structures, patient age, primary compared with recurrent disease, 30 and pathological features are also currently being studied. Prognostic factors, once firmly established, may assist the clinician in formulating therapeutic decisions.…”

Section: Neurosurgical Focus / Volume 10 / March 2001mentioning

confidence: 99%

Skull base chordomas: overview of disease, management options, and outcome

Lanzino¹,

As²,

Mb³

et al. 2001

FOC

101

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Cranial base chordomas are locally invasive tumors that, from a midline, clival location, extend in different directions and display various patterns of skull base invasion. Although histologically benign, their invasive nature makes true “oncological” resection virtually impossible to achieve in most cases, despite modern skull base surgical techniques. Moreover, because of the tumor's location and proximity to critical neural and vascular structures, surgery-related morbidity can be significant when an aggressive resection is undertaken. Cytoreductive surgery assumes a critical role in the management of these lesions. The choice of surgical approach and the extent of resection are dependent on several factors: location and extension of the tumor, the surgeon's philosophy and familiarity with a specific approach, and the patient's preexisting clinical status. Proton-beam radiotherapy seems to be effective as an adjunct to surgery in achieving local tumor control. The timing of radiation therapy, however, remains controversial. Gamma knife surgery has been proposed as an adjunctive therapy, but the limited experience and short follow-up periods do not permit formulation of meaningful conclusions at this time. Recurrences are common, although in a subset of patients prolonged disease-free survival is demonstrated.

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Base of skull chordoma. A correlative study of histologic and clinical features of 62 cases

Cited by 164 publications

References 21 publications

Clinicopathological characteristics of chordoma - an institutional experience and a review of literature

Clinicopathological characteristics of chordoma - an institutional experience and a review of literature

Prognostic factors of sacral chordoma after surgical therapy: a study of 36 patients

Skull base chordomas: overview of disease, management options, and outcome

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