Chordoma of the Mobile Spine: Fifty Years of Experience

Boriani, Stefano; Bandiera, Stefano; Biagini, R.; Bacchini, Patrizia; Boriani, Luca; Cappuccio, Michele; Chevalley, F; Gasbarrini, A.; Picci, Piero; Weinstein, James Neil

doi:10.1097/01.brs.0000200038.30869.27

Cited by 387 publications

(294 citation statements)

References 39 publications

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“…Currently, MRI is the preferred imaging modality for preoperative diagnosis and assessment. MRIs can detect small chordomas before major symptoms develop, improve patient prognosis and increases the chance of the tumour being resectable [6]. Chordomas appear hypo-or iso-intense on T1-weighted images, whereas on T2-weighted images they appear hyperintense [2].…”

Section: Discussionmentioning

confidence: 99%

“…Chordomas are generally chemo-resistant, however imatinib mesylate is showing promise in clinical trials [1,7] with a prospective multicentred phase II study of 55 patients revealing a 73% clinical benefit rate after 1 year [3]. While recent developments in radiotherapy and chemotherapy show promise, there is a lack of controlled, long-term follow-up studies to guide future practice [6].…”

Section: Discussionmentioning

confidence: 99%

“…Studies show that en bloc resections can improve survival rate and decrease rates of local recurrence and thus are often utilised in chordoma treatment [6]. En bloc resection refers to complete tumour removal in one piece.…”

Section: En Bloc Resectionmentioning

confidence: 99%

“…Recurrence appears an average of 26 months post-treatment. Despite some cases of long survival (up to 10 years), the pain/disability caused by tumour regrowth causes poor quality of life [6].…”

Section: En Bloc Resectionmentioning

confidence: 99%

“…Complications include major neurovascular injury, excessive bleeding, tumour cell contamination, spinal instability or abdominal herniation (following anterior approach) [6,7].…”

Section: En Bloc Resectionmentioning

confidence: 99%

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Extensive lumbar chordoma and unique reconstructive approach

Sivabalan

Mobbs

2011

Eur Spine J

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Chordomas are rare, malignant, low grade, primary bone tumours arising from notochord remnants. They are rarely located in the lumbar spine and consequently, the literature is lacking about the condition. There are very few case reports on the technical aspects of resection of extensive lesions such as our case. Treatment can be potentially curative only if aggressive surgical resection is utilised. We describe a case of an extensive lumbar chordoma, and demonstrate the possibility of performing a staged anterior and posterior total tumour resection with planned transgression in conjunction with an expandable cage, vascularised rib, fibula and latissimus dorsi grafts for the treatment and reconstruction of extensive spinal disease with this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: En Bloc Resectionmentioning

confidence: 99%

Section: En Bloc Resectionmentioning

confidence: 99%

“…Complications include major neurovascular injury, excessive bleeding, tumour cell contamination, spinal instability or abdominal herniation (following anterior approach) [6,7].…”

Section: En Bloc Resectionmentioning

confidence: 99%

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Extensive lumbar chordoma and unique reconstructive approach

Sivabalan

Mobbs

2011

Eur Spine J

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Comparison of Oncologic Outcomes and Treatment-Related Toxicity of Carbon Ion Radiotherapy and En Bloc Resection for Sacral Chordoma

et al. 2022

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IMPORTANCE Maximal resection is the preferred management for sacral chordomas but can be associated with unacceptable morbidity. Outcomes with radiotherapy are poor. Carbon ion radiotherapy (CIRT) is being explored as an alternative when surgery is not preferred. OBJECTIVE To compare oncologic outcomes and treatment-related toxicity of CIRT and en bloc resection for sacral chordoma. DESIGN, SETTING, AND PARTICIPANTSUnivariable logistic regression was performed to evaluate the association between treatment type and oncologic and toxicity outcomes in this retrospective cohort study. Nearest-neighbor propensity score matching was used to match the CIRT cohort with the en bloc resection cohort and 10 National Cancer Database (NCDB) cohorts separately, with the objective of obtaining more homogeneous cohorts when comparing treatments. Patient-and tumorrelated characteristics from 2 institutional cohorts were collected for patients diagnosed with sacral

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Weekly cisplatin with or without imatinib in advanced chordoma: A retrospective case‐series analysis from the Italian Rare Cancers Network

Baldi

Vullo

Grignani

et al. 2022

Cancer

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Background To report on a retrospective case‐series analysis of weekly cisplatin (wCDDP) as a single agent or combined with imatinib (wCDDP/I) in patients with advanced chordoma treated within the Italian Rare Cancer Network. Methods Adult patients with a diagnosis of advanced, brachyury‐positive chordoma, treated from April 2007 to October 2020 with wCDDP or wCDDP/I were retrospectively identified. Imatinib was withheld at the same time as wCDDP. Response according to Response Evaluation Criteria in Solid Tumors, overall survival (OS), and progression‐free survival (PFS) were analyzed. Results Thirty‐three consecutive patients were identified (wCDDP as front‐line n = 8 [24.2%]; wCDDP as a further line n = 25 [75.8%]; prior imatinib n = 25 [75.8%]; evidence of progression before starting wCDDP n = 33). Of 32 patients evaluable for response (wCDDP, n = 22 [68.8%]; wCDDP/I, n = 10 [31.3%]), best response was stable disease (SD) in 27 patients (84.3%) and progression in 5 patients (15.6%). At a median follow‐up of 54 months, the median OS (m‐OS) was 30.3 months (interquartile range [IQR], 18.1‐56.6), the m‐PFS was 8.0 months (IQR, 5.1‐17.0), the 6‐month PFS rate was 65.2%, and the 12‐month PFS rate was 30.3%. Of 22 patients who received wCDDP, the best response was SD in 18 patients (81.8%) and progression in 4 patients (18.2%), and the m‐PFS was 8.0 months (IQR, 5.1‐17.0 months). Of 10 patients who received treatment with wCDDP/I, the best response was SD in 9 patients (90%) and progression in 1 patient (10%), and the m‐PFS was 9.3 months (IQR, 4.9‐26.5 months). Conclusions This series suggests that wCDDP, both as a single agent and combined with imatinib, has antitumor activity in chordoma. Although no dimensional responses were observed, 65% and 30% of previously progressive patients were progression‐free at 6 and 12 months, respectively. A prospective study is warranted.

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Chordoma of the Mobile Spine: Fifty Years of Experience

Abstract: The only treatment protocol associated with CDF at follow-up longer than 5 years is margin-free en bloc resection.

Cited by 387 publications

References 39 publications

Extensive lumbar chordoma and unique reconstructive approach

Extensive lumbar chordoma and unique reconstructive approach

Comparison of Oncologic Outcomes and Treatment-Related Toxicity of Carbon Ion Radiotherapy and En Bloc Resection for Sacral Chordoma

Weekly cisplatin with or without imatinib in advanced chordoma: A retrospective case‐series analysis from the Italian Rare Cancers Network

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