Iatrogenic seeding of skull base chordoma following endoscopic endonasal surgery

Cabral, David T. Fernandes; Zenonos, Georgios A.; Fernández-Miranda, Juan C.; Wang, Eric; Gardner, Paul A.

doi:10.3171/2017.6.jns17111

Cited by 16 publications

(11 citation statements)

References 14 publications

(17 reference statements)

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“…It can be difficult to attribute a recurrence to “seeding” and no definitive consensus has emerged regarding this; however, it has been suggested that minimally invasive techniques such as the EEA may limit seeding . In a large series, specifically examining iatrogenic seeding following 173 endoscopic endonasal resections for skull‐base chordomas, Fernandes Cabral et al . noted a 1.2% rate of seeding.…”

Section: Clival Tumorsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

Self Cite

152

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Clival Tumorsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

Self Cite

152

279

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“…Often, the aim of surgery is to completely resect a tumor (gross total resection), but partial resections are sometimes the only clinical option. Various tumors including chordoma [ 31 ] and mixed epithelial stromal tumor of the kidney [ 32 ] have also shown evidence of tumor seeding as a result of partial resections. Unfortunately, even gross total resection of tumors can result in local dissemination of cells.…”

Section: Local Effects Of Surgerymentioning

confidence: 99%

Potential impact of invasive surgical procedures on primary tumor growth and metastasis

Alieva

Rheenen

Broekman

2018

Clin Exp Metastasis

174

141

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Surgical procedures such as tumor resection and biopsy are still the gold standard for diagnosis and (determination of) treatment of solid tumors, and are prognostically beneficial for patients. However, growing evidence suggests that even a minor surgical trauma can influence several (patho) physiological processes that might promote postoperative metastatic spread and tumor recurrence. Local effects include tumor seeding and a wound healing response that can promote tumor cell migration, proliferation, differentiation, extracellular matrix remodeling, angiogenesis and extravasation. In addition, local and systemic immunosuppression impairs antitumor immunity and contributes to tumor cell survival. Surgical manipulation of the tumor can result in cancer cell release into the circulation, thus increasing the chance of tumor cell dissemination. To prevent these undesired effects of surgical interventions, therapeutic strategies targeting immune response exacerbation or alteration have been proposed. This review summarizes the current literature regarding these local, systemic and secondary site effects of surgical interventions on tumor progression and dissemination, and discusses studies that aimed to identify potential therapeutic approaches to prevent these effects in order to further increase the clinical benefit from surgical procedures.

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“…Indeed, these bone-eroding, infiltrative tumors often present with an aggressive behavior, multiple loco-regional recurrences and, at late stages, also with possible metastases to target organs (Frezza et al, 2019;Stacchiotti et al, 2015;Cavallo et al, 2020). According to large clinical series, more than 50% of the patients with a CC develop one or more loco-regional recurrences, even after gross tumor resection (GTR) and adjuvant radiotherapy (Frezza et al, 2019;Stacchiotti et al, 2015;Cavallo et al, 2020;Yaniv et al, 2020;Snyderman and Gardner, 2020;Kim et al, 2018;Fernandes Cabral et al, 2018). Usually, recurrences occur after 5-10 years from the initial treatment, and represent a challenge for all the specialists involved in the management of these patients (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Usually, recurrences occur after 5-10 years from the initial treatment, and represent a challenge for all the specialists involved in the management of these patients (i.e. neurosurgeons, radiation/medical oncologist and specialists in palliative cares) (Frezza et al, 2019;Stacchiotti et al, 2015;Cavallo et al, 2020;Yaniv et al, 2020;Snyderman and Gardner, 2020;Kim et al, 2018;Fernandes Cabral et al, 2018). Surgical and adjuvant treatments of CCs have significantly improved in last years (Frezza et al, 2019;Stacchiotti et al, 2015;Cavallo et al, 2020).…”

Section: Introductionmentioning

confidence: 99%