Microsurgical versus endoscopic trans-sphenoidal approaches for clivus chordoma: a pooled and meta-analysis

Cannizzaro, Delia; Tropeano, Maria Pia; Milani, Davide; Spaggiari, Riccardo; Zaed, Ismail; Mancarella, Cristina; Lasio, Giovanni; Fornari, Maurizio; Servadei, Franco; Cardia, Andrea

doi:10.1007/s10143-020-01318-y

Cited by 19 publications

(22 citation statements)

References 21 publications

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“…For what concerns clinical applications, some fields of neurosurgery are particularly relevant. In fact, imaging modalities such as computed tomography and magnetic resonance are indeed crucial in current practice for optimal pre-operative planning in order to determine the optimal approach for the surgery, especially in complex skull base approaches (17)(18)(19)(20)(21)(22)(23). AR is used for guidance of screw insertion in pedicles during minimally invasive spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

Augmented Reality in Neurosurgery, State of Art and Future Projections. A Systematic Review

et al. 2022

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BackgroundThe use of augmented reality (AR) is growing in medical education, in particular, in radiology and surgery. AR has the potential to become a strategic component of neurosurgical training courses. In fact, over the years, there has been a progressive increase in the application of AR in the various fields of neurosurgery. In this study, the authors aim to define the diffusion of these augmented reality systems in recent years. This study describes future trends in augmented reality for neurosurgeons.MethodsA systematic review of the literature was conducted to identify research published from December 1st, 2011 to November 30th, 2021. Electronic databases (PubMed, PubMed Central, and Scopus) were screened. The methodological quality of studies and extracted data were assessed for “augmented reality” and “neurosurgery”. The data analysis focused on the geographical distribution, temporal evolution, and topic of augmented reality in neurosurgery.ResultsA total of 198 studies have been included. The number of augmented reality applications in the neurosurgical field has increased during the last 10 years. The main topics on which it is mostly applied are spine surgery, neuronavigation, and education. The geographical distribution shows extensive use of augmented reality in the USA, Germany, China, and Canada. North America is the continent that uses augmented reality the most in the training and education of medical students, residents, and surgeons, besides giving the greatest research contribution in spine surgery, brain oncology, and surgical planning. AR is also extensively used in Asia for intraoperative navigation. Nevertheless, augmented reality is still far from reaching Africa and other countries with limited facilities, as no publications could be retrieved from our search.ConclusionsThe use of AR is significantly increased in the last 10 years. Nowadays it is mainly used in spine surgery and for neurosurgical education, especially in North America, Europe and China. A continuous growth, also in other aspects of the specialty, is expected in the next future.

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Section: Discussionmentioning

confidence: 99%

Augmented Reality in Neurosurgery, State of Art and Future Projections. A Systematic Review

et al. 2022

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“…Chordomas are dual epithelial-mesenchymal tissue tumors that show slow progression, but despite their low malignancy, chordomas always manifest a high recurrence rate and frequently lead to local invasion and distant metastasis in advanced stages (52,53). Chordoma is resistant to conventional chemotherapy and radiotherapy and surgical eradication remains challenging due to the complicated anatomical location of the tumors; patients are also vulnerable to relapse.…”

Section: Discussionmentioning

confidence: 99%

Proteomics and phosphoproteomics of chordoma biopsies reveal alterations in multiple pathways and aberrant kinases activities

Hang

Ouyang²,

Wei³

et al. 2022

Front. Oncol.

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BackgroundChordoma is a slow-growing but malignant subtype of bone sarcoma with relatively high recurrence rates and high resistance to chemotherapy. It is urgent to understand the underlying regulatory networks to determine more effective potential targets. Phosphorylative regulation is currently regarded as playing a significant role in tumorigenesis, and the use of tyrosine kinase inhibitors in clinical practice has yielded new promise for the treatment of a variety of sarcoma types.Materials and methodsWe performed comprehensive proteomic and phosphoproteomic analyses of chordoma using four-dimensional label-free liquid chromatography–tandem mass spectrometry (LC-MS/MS) and bioinformatics analysis. The potential aberrantly expressed kinases and their functions were validated using western blotting and CCK-8 assays.ResultsCompared with paired normal muscle tissues, 1,139 differentially expressed proteins (DEPs) and 776 differentially phosphorylated proteins (DPPs) were identified in chordoma tumor tissues. The developmentally significant Wnt-signaling pathway and oxidative phosphorylation were aberrant in chordoma. Moreover, we predicted three kinases (AURA, CDK9, and MOK) with elevated activity by kinase-pathway network analysis (KiPNA) and verified their increased expression levels. The knockdown of these kinases markedly suppressed chordoma cell growth, and this was also the case for cells treated with the CDK9 inhibitor AZD4573. We additionally examined 208 proteins whose expression and phosphorylation levels were synergetically altered.ConclusionsWe herein depicted the collective protein profiles of chordomas, providing insight into chordomagenesis and the potential development of new therapeutic targets.

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“…This could be due to some differences in dural reconstruction, lumbar drainage, and tumor characteristics. According to past studies, the risk of CSF leak after EEA or trans-sphenoidal surgery ranges from 0 to 35% [ 6 , 12 , 14 , 15 , 16 , 17 ]. In our study, the risk of CSF leak after EEA was 11% (four of 36), which falls into this range.…”

Section: Discussionmentioning

confidence: 99%

Mayo Clinic Clival Chordoma Case Series: Impact of Endoscopic Training on Clinical Care

Hong

Laack

Mahajan

et al. 2022

Cancers

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The management of clival chordoma in our group shifted around 2013 to mostly endoscopic, and proton beam was introduced for our multidisciplinary team. Consecutive patients who had surgical resection from 1987 to 2021 were reviewed. A total of 58 patients (39 patients after 2013) were analyzed. The mean tumor size was 3.7 cm, and the most common location was the upper clivus (43%). Compared to before 2013, after 2013, the endoscopic endonasal approach was more common (90%, p < 0.001), and more gross or near total resections (64%, p = 0.002) were attained. Ten cases (17%) were revision surgeries referred from elsewhere, and three cases (5%) underwent additional surgery elsewhere before adjuvant radiation. The postoperative cerebrospinal fluid leak occurred in 7%. Post-operative new cranial nerve deficits occurred in 32% before 2013, compared to 2.6% after 2013 (p = 0.004). For cases before 2013, 10 patients (53%) recurred during the median follow-up of 144 months (mean, 142 months), whereas for cases after 2013, seven patients (18%) recurred with a median follow-up of 35 months (mean, 42 months). 5-year progression-free survival was 58%, and 5-year overall survival was 87%. A specialized multidisciplinary team improved the resection rate compared to a historical cohort with an excellent morbidity profile.

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Microsurgical versus endoscopic trans-sphenoidal approaches for clivus chordoma: a pooled and meta-analysis

Cited by 19 publications

References 21 publications

Augmented Reality in Neurosurgery, State of Art and Future Projections. A Systematic Review

Augmented Reality in Neurosurgery, State of Art and Future Projections. A Systematic Review

Proteomics and phosphoproteomics of chordoma biopsies reveal alterations in multiple pathways and aberrant kinases activities

Mayo Clinic Clival Chordoma Case Series: Impact of Endoscopic Training on Clinical Care

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