Primary Skull Base Chondrosarcomas: A Systematic Review

Palmisciano, Paolo; Haider, Ali S; Sabahi, Mohammadmahdi; Nwagwu, Chibueze D.; Bin-Alamer, Othman; Scalia, Gianluca; Umana, Giuseppe Emmanuele; Cohen-Gadol, Aaron; Ahmadieh, Tarek Y. El; Yu, Kenny; Pathmanaban, Omar

doi:10.3390/cancers13235960

Cited by 35 publications

(42 citation statements)

References 65 publications

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“…The main therapeutic goals consist in providing clinical improvement and local tumor control, while minimizing complication risks and quality-of-life impairment [ 59 , 60 , 61 ]. Microsurgical tumor resection represents the current mainstay treatment, by allowing decompression of the CVJ neuro-vascular structures and prompt symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Palmisciano

Ferini²,

Watanabe

et al. 2022

Current Oncology

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Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Palmisciano

Ferini²,

Watanabe

et al. 2022

Current Oncology

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“…Although survival rates were significantly superior at 12 months ( p = 0.020), 18 months ( p = 0.019), and 24 months ( p = 0.006) in the denosumab cohort, we note that all deaths occurred for non-oncological and unrelated conditions, comprising older age and medical comorbidities [ 11 , 26 , 27 , 34 ]. In addition, years of publication were largely different among the three treatments, more recent for denosumab studies, which may have contributed to such survival differences following the important advances in the management of oncological patients introduced during the past decade [ 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Optimal Management of Inoperable Giant Cell Tumors of the Spine: A Systematic Review and Meta-Analysis

Palmisciano

Ferini²,

Chen

et al. 2022

Cancers

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Background: Surgical resection remains the preferred treatment in spine giant cell tumors (SGCTs), but it is not always feasible. Conservative strategies have been studied for inoperable cases. We systematically reviewed the literature on inoperable SGCTs treated with denosumab, radiotherapy or selective arterial embolization (SAE). Methods: PubMed, Scopus, Web-of-Science, Ovid-EMBASE, and Cochrane were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to include studies of inoperable SGCTs treated with denosumab, radiotherapy or SAE. Treatment outcomes were analyzed and compared with a random-effect model meta-analysis. Results: Among the 17 studies included, 128 patients received denosumab, 59 radiotherapy, and 43 SAE. No significant differences in baseline patient characteristics were found between the three groups. All strategies were equally effective in providing symptom improvement (p = 0.187, I2 = 0%) and reduction in tumor volume (p = 0.738, I2 = 56.8%). Rates of treatment-related complications were low (denosumab: 12.5%; radiotherapy: 8.5%; SAE: 18.6%) and comparable (p = 0.311, I2 = 0%). Patients receiving denosumab had significantly lower rates of local tumor recurrence (10.9%) and distant metastases (0%) compared to patients receiving radiotherapy (30.5%; 8.5%) or SAE (35.6%; 7%) (p = 0.003, I2 = 32%; p = 0.002, I2 = 47%). Denosumab was also correlated with significantly higher overall survival rates at 18 months (99.2%) and 24 months (99.2%) compared to radiotherapy (91.5%; 89.6%) and SAE (92.5%; 89.4%) (p = 0.019, I2 = 8%; p = 0.004, I2 = 23%). Mortality was higher in patients receiving SAE (20.9%) or radiotherapy (13.6%) compared to denosumab (0.8%) (p < 0.001), but deaths mostly occurred for unrelated diseases. Conclusions: Denosumab, radiotherapy, and SAE are safe and effective for inoperable SGCTs. Clinical and radiological outcomes are mostly comparable, but denosumab may provide superior tumor control.

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“…In the general population, the prevalence of primary malignant bone tumors is estimated to be 1:100,000, of which 17%–24% are chondrosarcomas. 20, 21 Giuffrida et al analyzed a total of 2890 chondrosarcoma cases from 1973 to 2003 using SEER dataset and found that patients with clear cell chondrosarcoma had the highest 5-year survival rate (100%), followed by patients with common chondrosarcoma (70%), and patients with dedifferentiated chondrosarcoma had the worst survival rate. 22 Surgical resection is the primary approach and is considered the “gold-standard” for the treatment of chondrosarcoma.…”

Section: Discussionmentioning

confidence: 99%

Effect of surgery and radiotherapy on overall survival in patients with chondrosarcoma: A SEER-based study

Wang

Song

Liu

et al. 2022

J Orthop Surg (Hong Kong)

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Purpose Chondrosarcoma is an orthopedic malignancy, and the purpose of this study was to evaluate the effect of surgery and radiotherapy (RT) on the survival of patients with chondrosarcoma. Methods Data were obtained from the SEER database for patients diagnosed with chondrosarcoma between 1988 and 2015. All patients were divided into surgery, RT, surgery + RT, and no surgery/no RT groups. Kaplan–Meier curves were used to analyze the overall survival and cancer-specific survival of patients in different treatment groups. The propensity score matching was used to balance baseline covariates between patients in the surgery and surgery + RT groups and in the RT and surgery + RT groups. Results Data from 3756 patients with chondrosarcoma were included in this study. The number of patients who underwent surgery, RT, surgery + RT, and no surgery or RT was 2885 (76.8%), 112 (3.0%), 403 (10.7%), and 356 (9.5%), respectively. Multivariate Cox regression models showed that treatment modality was independent risk factor for OS and CSS. Before PSM, Kaplan–Meier curves showed that OS and CSS were highest in the surgery group and lowest in the RT group. After PSM, although there was no significant difference in OS ( p = .13) and CSS ( p = .22) between the surgery and surgery + RT group, OS was longer in the surgery group than in the surgery + RT group. Additionally, OS ( p < .001) and CSS ( p = .009) were longer in the surgery + RT group than in the RT group after PSM. Conclusion Surgical resection was the key approach for the treatment of chondrosarcoma, while RT confers no significant advantage in improving patient survival time.

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Primary Skull Base Chondrosarcomas: A Systematic Review

Cited by 35 publications

References 65 publications

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Evaluating the Optimal Management of Inoperable Giant Cell Tumors of the Spine: A Systematic Review and Meta-Analysis

Effect of surgery and radiotherapy on overall survival in patients with chondrosarcoma: A SEER-based study

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