Surgical treatment of sacral chordoma: survival and prognostic factors

Ruosi, Carlo; Colella, G; Donato, Sigismondo Luca Di; Granata, Francescopaolo; Salvatore, Mariano Giuseppe Di; Fazioli, Flavio

doi:10.1007/s00586-015-4276-4

Cited by 31 publications

(9 citation statements)

References 19 publications

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“…En bloc resection of sacral chordoma is a technically demanding operation with potential for long term benefit but high morbidity. Many single and multi-institution studies have reported predictors of OS and LR 5 , 6 , 9 - 24 ; however, complication data and their effect on survival, recurrence, and functional outcome are rarely included. In the present series, a negative margin resection was associated with a significantly decreased risk of LR but did not maintain significance for OS.…”

Section: Discussionmentioning

confidence: 99%

“…Though prior studies have reported predictive factors of overall survival (OS) and local recurrence (LR), large series of patients undergoing en bloc resection of sacral chordomas are rare. 5 , 6 , 9 - 24 Previously described predictive factors of OS and LR have included high sacral location, age, extent of tumor invasion, and previous intralesional surgery. 10 , 11 , 14 , 17 , 25 Few studies have focused on the perioperative morbidity associated with these procedures, 13 and several do not report complication rates at all.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Zuckerman

Lee

Chang

et al. 2021

Global Spine Journal

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Study Design: Retrospective case series. Objective: To determine predictive factors of overall survival (OS) and local recurrence (LR), report complications, and assess the impact of complications on survival, recurrence, and function in patients undergoing en bloc resection of sacral chordoma. Methods: This retrospective case series was obtained from a prospective database (1995-2016). All patients underwent en bloc resection of sacral chordoma. Demographic, perioperative, and complication data were collected. Outcomes included: overall survival(OS), local recurrence(LR), and complications. Survival analysis with multivariable cox regression was performed. Results: Among 50 patients, median follow-up was 5.3 years (range = 1.3-17.2). The majority (82%) underwent a negative margin resection. Survival: 17 patients died (34%) with a median OS of 10.0 years (range = 1.3-17.2). Multivariable cox regression revealed that a negative margin resection was not significantly associated with improved survival (HR = 3.35, 95%CI 0.87-12.80, P = .078). Recurrence: 20 patients (40%) experienced LR with a median time of 6.2 years (range = 0-16.9). Multivariable cox regression revealed that a negative margin resection was associated with a significant decreased risk of LR (HR = 4.96, 95%CI 1.84-13.34, P = 0.002,). A 62% overall complication rate was seen (42% major), with 26% reoperation rate. Of the reoperations, 54% were delayed (>6 weeks after the index surgery). Multivariable cox regression demonstrated that neither major complication nor reoperation significantly impacted OS (HR = 0.62, 95%CI 0.22-1.79, P = 0.380), LR (HR = 1.28, 95%CI 0.49-3.36, P = 0.611), or functional outcomes (OR = 2.94, 95%CI 0.25-34.8, P = 0.393). Conclusions: Negative margin resection was associated with decreased LR. Neither major complication nor reoperation significantly impacted OS, LR, or functional outcome. Though additional studies are needed, it appears that despite the morbidity associated with sacral chordoma resection, the long-term clinical outcomes are favorable.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Zuckerman

Lee

Chang

et al. 2021

Global Spine Journal

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“…Most of the reports related to chordoma evaluated primary chordomas and recurrent chordomas en bloc, but we focused on residual or recurrent chordomas. 21,29,30 Ailon et al 6 suggested that further complete surgical resection can be considered for local recurrent chordoma, even if the management of recurrent chordoma is challenging and may be palliative. We supposed that follow-up MR imaging using ADC mapping could discriminate small chordomas with an aggressive potential from those without it; this discrimination could allow a short follow-up or early salvage therapy (further surgical resection) that would likely be successful or effective.…”

Section: Discussionmentioning

confidence: 99%

Role of the Apparent Diffusion Coefficient as a Predictor of Tumor Progression in Patients with Chordoma

Sasaki

Moritani

Belay³

et al. 2018

AJNR Am J Neuroradiol

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“…However, many patients suffer local recurrence and metastasis even if they have received complete tumor resection. It is reported that local recurrence rate is as high as 30-85%, and the postoperative local recurrence rate is considered to be the most important predictor of death (Chen et al, 2011;Kayani et al, 2014;Ruosi et al, 2015;Denaro et al, 2020). Through the preliminary clinical studies, we have found that local recurrence of chordoma is partly related to the invasive nature of the tumor itself (Chen et al, 2011;Zhang et al, 2014a).…”

Section: Introductionmentioning

confidence: 97%

LncRNA NONHSAT114552 Sponges miR-320d to Promote Proliferation and Invasion of Chordoma Through Upregulating NRP1

et al. 2021

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Chordoma is a relatively rare malignant bone tumor with high local recurrence. To date, the mechanism remains unclear. lncRNAs play a pivotal role in tumorigenesis by acting as competitive endogenous RNAs of microRNAs. However, the biological role of lncRNA is still unclear in chordoma. In this research, our aim is to investigate the roles and regulation mechanisms of lncRNA NONHSAT114552 in chordoma development. The expression level of NONHSAT114552 and miR-320d in chordoma tissues was determined by qRT-PCR. Meantime, the correlation between NONHSAT114552 and clinical prognosis was also studied. Bioinformatics analysis and luciferase reporter assays were used to verify the relationship between NONHSAT114552 and miR-320d, and between miR-320d and Neuropilin 1 (NRP1). In addition, effects of NONHSAT114552 on chordoma cells (U-CH1 and U-CH2) proliferation and invasion and its regulation on miR-320d were also evaluated. Furthermore, the influences of NONHSAT114552/miR-320d/NRP1 axis on chordoma tumorigenesis were investigated in vivo. NONHSAT114552 was overexpressed while miR-320d was down-regulated in chordoma tissue compared to fetal nucleus pulposus. Kaplan-Meier survival analysis showed that NONHSAT114552 overexpression was associated with patients’ poor prognosis. Knockdown of NONHSAT114552 significantly suppressed chordoma cell proliferation and invasion. In vitro studies confirmed that NONHSAT114552 acted as ceRNA to regulate NRP1 by directly sponging miR-320d, thus facilitating chordoma cell proliferation and invasion. In vivo study demonstrated that NONHSAT114552 moderated chordoma growth by sponging miR-320d to regulating NRP1. Our findings indicate that lncRNA NONHSAT114552 exhibits a critical role in the tumorigenesis and development of chordoma and it may become one potential prognostic marker and therapeutic target for this disease. .

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Surgical treatment of sacral chordoma: survival and prognostic factors

Abstract: Solid survival at long-term follow-up can be achieved by a surgical resection performed with wide margins.

Cited by 31 publications

References 19 publications

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Outcomes of Surgery for Sacral Chordoma and Impact of Complications: A Report of 50 Consecutive Patients With Long-Term Follow-Up

Role of the Apparent Diffusion Coefficient as a Predictor of Tumor Progression in Patients with Chordoma

LncRNA NONHSAT114552 Sponges miR-320d to Promote Proliferation and Invasion of Chordoma Through Upregulating NRP1

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