A Comparative Study Between Traditional Microscopic Surgeries and Endoscopic Endonasal Surgery for Skull Base Chordomas

Oishi, Yumiko; Tamura, Ryota; Takahashi, Satoshi; Morimoto, Yukina; Sato, Mizuto; Horikoshi, Tomo; Hassaan, Shady; Yoshida, Kazunari; Toda, Masahiro

doi:10.1016/j.wneu.2019.11.113

Cited by 17 publications

(17 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To achieve maximal resection, MLOA was still required in selected cases. We did not nd a signi cant difference in the GTR rate between EMA and MLOA, which was consistent with the previous ndings of our group and others [30,34,38]. This supports the philosophy that a team focusing on skull-base disease should master different approaches [1].…”

Section: Choice Of Surgical Approachsupporting

confidence: 92%

“…Adjuvant RT is a widely accepted treatment for residual chordomas [40,19], although no strong evidence supports it [31]. We found that PFS and CSS were signi cantly longer in patients with pre-recurrence RT than in other patients, which is similar to prior studies [14,34]. In addition, the PFS in the late-RT group was shortest in the present series (data not shown); however, the CSS was still longer than that of the patients who had no RT.…”

Section: Timing Of Rt and Outcomesupporting

confidence: 82%

“…Maximum resection was traditionally recommended with the goal of marginal resection [24,25,30]. The recurrence rate ranges from 16-45% at 10 years after marginal resection, and most recurrences occur within 2 or 3 years [23,34,14]. After a more detailed analysis, we found that the advantage of marginal resection was mainly contributed by GTR and that no obvious differences were found among NTR, STR and PR.…”

Section: Resection Rate and Outcomementioning

confidence: 76%

“…Similarly, Olabisi Sanusi et al found that a second dose of RT at any point either as sole treatment or as adjuvant treatment for recurrence showed a statistically signi cant effect on PFS (P = 0.009) [22]. Taken together, these ndings indicate that adjuvant RT is an independent factor for better outcomes [7,34], and the importance of pre-recurrence RT is worth emphasizing. Once recurrence occurs, postsurgical RT is also recommended to prolong CSS when the patient has no RT history [24].…”

Section: Timing Of Rt and Outcomementioning

confidence: 85%

See 3 more Smart Citations

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

bai

Shi

et al. 2021

Preprint

View full text Add to dashboard Cite

OBJECTIVE: Skull-base chordoma (SBC) is rare and one of the most challenging diseases to treat. We aimed to assess the optimal timing of adjuvant radiation therapy (RT) and evaluate the factors that influence resection and long-term outcomes.METHODS: In total, 284 patients with 382 surgeries were enrolled in this retrospective study. Postsurgically, 64 patients underwent RT before recurrence (pre-recurrence RT), and 47 patients underwent RT after recurrence. During the first attempt to achieve gross-total resection (GTR), when the entire tumor was resected, 268 patients were treated with an endoscopic midline approach, and 16 patients were treated with microscopic lateral approaches. Factors associated with the success of GTR were identified using c2 and logistic regression analyses. Risk factors associated with chordoma-specific survival (CSS) and progression-free survival (PFS) were evaluated with the Cox proportional hazards model.RESULTS: In total, 74.6% of tumors were marginally resected [GTR (40.1%); near-total resection (34.5%)]. History of surgery, large tumor volumes and tumor locations in the lower clivus were associated with a lower GTR rate. The mean follow-up period was 43.9 months. At last follow-up, 181 (63.7%) patients were alive. RT history, histologic subtype (dedifferentiated and sarcomatoid), non-GTR, no postsurgical RT, and the presence of metastasis were associated with poorer CSS. Patients with pre-recurrence RT had the longest PFS and CSS, while patients without postsurgical RT had the worst outcome.CONCLUSION: GTR is the goal of initial surgical treatment. Pre-recurrence RT would improve outcome regardless of GTR.

show abstract

Section: Choice Of Surgical Approachsupporting

confidence: 92%

Section: Timing Of Rt and Outcomesupporting

confidence: 82%

Section: Resection Rate and Outcomementioning

confidence: 76%

Section: Timing Of Rt and Outcomementioning

confidence: 85%

See 2 more Smart Citations

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

bai

Shi

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…A relatively recent meta-analysis could not detect significant differences between the 2 approaches [ 24 ]. This equivalence was recently confirmed in several retrospective comparisons [ 14 , 17 , 33 ]. After surgical resection, high-dose radiation therapy is therefore indicated and can improve overall survival and local control, and particle therapy is considered the radiation modality of choice [ 15 , 17 , 31 , 34 ].…”

Section: Established Treatment Strategymentioning

confidence: 55%

A Review of Particle Therapy for Skull Base Tumors: Modern Considerations and Future Directions

Hug

Pelak

Frank

et al. 2021

International Journal of Particle Therapy

View full text Add to dashboard Cite

Skull base tumors constitute one of the established indications for particle therapy, specifically proton therapy. However, a number of prognostic factors, practical clinical management issues, and the emerging role of carbon ion therapy remain subjects of active clinical investigation. This review summarizes these topics, assesses the present status, and reflects on future research directions focusing on the management of chordomas, one of the most aggressive skull base tumors. In addition, the role of particle therapy for benign tumors of the skull base, including pituitary adenoma and acoustic neuroma, is reviewed.

show abstract

Endoscopic Resection of Sinonasal Tumors

Barrow

Helman

Solares

2022

Sinonasal and Skull Base Malignancies

View full text Add to dashboard Cite

A Comparative Study Between Traditional Microscopic Surgeries and Endoscopic Endonasal Surgery for Skull Base Chordomas

Cited by 17 publications

References 27 publications

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

A Review of Particle Therapy for Skull Base Tumors: Modern Considerations and Future Directions

Endoscopic Resection of Sinonasal Tumors

Contact Info

Product

Resources

About