The sacral chordoma margin

Radaelli, Stefano; Fossati, Piero; Stacchiotti, Silvia; Akiyama, Tsuyoshi; Asencio, José Manuel; Bandiera, Stefano; Boglione, Antonella; Boland, Patrick J.; Bolle, Stéphanie; Bruland, Øyvind S.; Brunello, Antonella; Bruzzi, P.; Campanacci, D; Cananzi, Ferdinando Carlo Maria; Capanna, Rodolfo; Casadei, Riccardo; Cordoba, Abel; Court, Charles; Tos, Angelo Paolo Dei; DeLaney, Thomas F.; Paoli, Antonino De; Pas, Tommaso Martino De; Desai, Atman; Brina, Lucia Di; Donati, Davide María; Fabbri, Nicola; Fiore, Maria Rosaria; Frezza, Anna Maria; Gambarotti, Marco; Gasbarrini, Antonio; Georg, Petra; Grignani, Giovanni; Hindi, Nadia; Hug, Eugen B.; Jones, Robin L.; Kawai, Akira; Krol, Augustinus D.G.; Grange, Franel le; Luzzati, Alessandro; Marquina, Gloria; Martín-Benlloch, Juan Antonio; Mazzocco, Ketti; Navarria, Federico; Navarria, Pierina; Parchi, Paolo Domenico; Patel, Shreyaskumar; Pennacchioli, Elisabetta; Petrongari, Maria Grazia; Picci, Piero; Pollock, Robin; Porcu, Luca; Quagliuolo, Vittorio; Sangalli, Claudia; Scheipl, Susanne; Scotto, Gennaro; Spałek, Mateusz; Steinmeier, Theresa; Timmermann, Beate; Trama, Annalisa; Uhl, Matthias; Valverde, Claudia; Varga, Péter Pál; Vergés, Ramona; Weber, Damien Charles; Zoccali, Carmine; Casali, Paolo G.; Sommer, Josh; Gronchi, Alessandro

doi:10.1016/j.ejso.2020.04.028

Cited by 40 publications

(19 citation statements)

References 45 publications

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“…The best available evidence supports margin-appropriate en bloc surgery to decrease local recurrence and improve survival. 2,3,[22][23][24][25][26][27][28] However, this is not always possible given the proximity to vital structures, such as the spinal cord, nerves, and vasculature. 2,26,29 Given their proximity to vital structures, between 35% and 65% of sacral chor- domas and approximately 21% of mobile spine chordomas are amenable to en bloc resection with negative surgical margins.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,[22][23][24][25][26][27][28] However, this is not always possible given the proximity to vital structures, such as the spinal cord, nerves, and vasculature. 2,26,29 Given their proximity to vital structures, between 35% and 65% of sacral chor- domas and approximately 21% of mobile spine chordomas are amenable to en bloc resection with negative surgical margins. 14,[30][31][32][33] Even when resection is feasible, microscopic satellite spread outside the planned resection site or failure to achieve surgical margins may lead to increased recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study

Dandurand

Fisher

Rhines

et al. 2021

Neurosurgical Focus

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OBJECTIVE Oncological resection of primary spine tumors is associated with lower recurrence rates. However, even in the most experienced hands, the execution of a meticulously drafted plan sometimes fails. The objectives of this study were to determine how successful surgical teams are at achieving planned surgical margins and how successful surgeons are in intraoperatively assessing tumor margins. The secondary objective was to identify factors associated with successful execution of planned resection. METHODS The Primary Tumor Research and Outcomes Network (PTRON) is a multicenter international prospective registry for the management of primary tumors of the spine. Using this registry, the authors compared 1) the planned surgical margin and 2) the intraoperative assessment of the margin by the surgeon with the postoperative assessment of the margin by the pathologist. Univariate analysis was used to assess whether factors such as histology, size, location, previous radiotherapy, and revision surgery were associated with successful execution of the planned margins. RESULTS Three hundred patients were included. The surgical plan was successfully achieved in 224 (74.7%) patients. The surgeon correctly assessed the intraoperative margins, as reported in the final assessment by the pathologist, in 239 (79.7%) patients. On univariate analysis, no factor had a statistically significant influence on successful achievement of planned margins. CONCLUSIONS In high-volume cancer centers around the world, planned surgical margins can be achieved in approximately 75% of cases. The morbidity of the proposed intervention must be balanced with the expected success rate in order to optimize patient management and surgical decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study

Dandurand

Fisher

Rhines

et al. 2021

Neurosurgical Focus

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“…Conventional chordomas possess some peculiar characteristics. They are slow growing tumors and are locally aggressive, invading surrounding structures including the bone and often compressing important structures such as cranial nerves or the spinal cord [ 4 ]. They are almost avascular, leading to strong hypoxia, and are composed of large, vacuolated, physaliphorous cells surrounded by an abundant mucoid extracellular matrix [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…As in the vast majority of bone sarcoma, chordoma patient management consists of surgical resection of the tumor [ 6 ]. The goal of resection is to obtain adequate margins, and the quality of surgery is the most important prognostic factor [ 4 ]. However, resection with adequate margins is achieved in roughly 50% of cases, mainly due to the location of the tumor in the vicinity of important structures [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The goal of resection is to obtain adequate margins, and the quality of surgery is the most important prognostic factor [ 4 ]. However, resection with adequate margins is achieved in roughly 50% of cases, mainly due to the location of the tumor in the vicinity of important structures [ 4 ]. In the case of inadequate margins, neoadjuvant therapy is combined with surgery.…”

Section: Introductionmentioning

confidence: 99%

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Aldehyde Dehydrogenase, a Therapeutic Target in Chordoma: Analysis in 3D Cellular Models

Locquet

Dechaume

Berchard

et al. 2021

Cells

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Chordomas are rare, slow-growing tumors of the axial skeleton. These tumors are locally aggressive and refractory to conventional therapies. Radical surgery and radiation remain the first-line treatments. Despite these aggressive treatments, chordomas often recur and second-line treatment options are limited. The mechanisms underlying chordoma radioresistance remain unknown, although several radioresistant cancer cells have been shown to respond favorably to aldehyde dehydrogenase (ALDH) inhibition. The study of chordoma has been delayed by small patient cohorts and few available models due to the scarcity of these tumors. We thus created cellular 3D models of chordoma by using low-adherence culture systems. Then, we evaluated their radiosensitivity using colony-forming and spheroid size assays. Finally, we determined whether pharmacologically inhibiting ALDH increased their radiosensitivity. We found that 3D cellular models of chordoma (derived from primary, relapse, and metastatic tumors) reproduce the histological and gene expression features of the disease. The metastatic, relapse, and primary spheroids displayed high, medium, and low radioresistance, respectively. Moreover, inhibiting ALDH decreased the radioresistance in all three models.

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Overall and net survival of patients with sarcoma between 2005 and 2010: Results from the French Network of Cancer Registries (FRANCIM)

Amadéo

Penel

Coindre

et al. 2022

Cancer

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BACKGROUND: Sarcomas are rare, heterogeneous, ubiquitously localized malignancies with many histologic subtypes and genomic patterns. The survival of patients with sarcoma has rarely been described based on this heterogeneity; therefore, the authors' objective was to estimate survival outcomes in patients who had sarcomas using the 2020 version of the World Health Organization classification of soft tissue and bone tumors. METHODS: Patients older than 15 years who had incident sarcoma diagnosed between 2005 and 2010 were extracted from 14 French population-based cancer registries covering 18% of the French metropolitan population. Vital status for each patient was actively followed up to June 30, 2013. Net survival (NS) was estimated using the unbiased Pohar-Perme method. RESULTS: Overall, 4202 patients were included. NS declined with increasing age at diagnosis. According to topographic groups, large 5-year NS disparities were observed, ranging from 47% among women with gynecologic sarcomas to 89% among patients with skin sarcomas. Patients with soft tissue, bone, and gastrointestinal sarcomas had 5-year NS rates of 53%, 61%, and 70%, respectively. Similar heterogeneity was observed according to histologic subtypes, with 5-year NS ranging from 19% for patients with angiosarcomas to 96% for patients with dermatofibrosarcomas. Patients with sarcoma who displayed missense mutations had a better 5-year NS (74%); those with MDM2-amplified sarcomas had the worst NS (45%). CONCLUSIONS: NS rates in patients with sarcoma are presented here for the first time based on the 2020 World Health Organization classification applied to population-based registry data. Large prognostic heterogeneity was observed based on age, topographic and histologic groups, and genomic alteration profiles, constituting a benchmark for future studies and clinical trials.

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The sacral chordoma margin

Cited by 40 publications

References 45 publications

Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study

Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study

Aldehyde Dehydrogenase, a Therapeutic Target in Chordoma: Analysis in 3D Cellular Models

Overall and net survival of patients with sarcoma between 2005 and 2010: Results from the French Network of Cancer Registries (FRANCIM)

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