Endoscopic Endonasal Surgery of Clival Chordomas: Preliminary Results

This article shows a series of patients affected by clival chordomas treated with endoscopic approach. Patients who underwent EEA or transoral approach (TO) for clival chordomas at our Skull Base Referral Center, have been retrospectively examined. Clinical symptoms, preoperative neuroradiological evaluation, surgical approach, complications and postoperative results were evaluated. Nine patients (4 females and 5 males; age range 45 –82 years, mean 61 years) were included. Chordomas involved upper clivus in 4/9 cases, with (2) or without (2) extension to the middle clivus, middle clivus alone in 2/9, lower clivus in 2/9, and the whole clivus in 1/9. Tumors were totally (4/9) or subtotally (5/9) removed. Skull base reconstru ction was performed with a multilayer technique (6/9) or a gasket-seal closure (1/9), using pedicled nasoseptal flaps, middle turbinate and mucoperichondrial grafts, fascia lata and synthetic fascia. No reconstruction was performed in 2 cases. Recurrence occurred in 4 cases, who underwent a new oper ation. All the other patients underwent proton-beam radiotherapy with no documented tumor growth at the last follow-up (median: 24.9 months; range: 7–36 months). EEA and TO resulted to be safe procedures for treatment of clival chordomas. These approaches may be used as an alternative to the tra ditional approaches, according to the extension of the pathology.
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

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ConclusionCompared to single-fraction SRS, a significant intrinsic benefit from hypofractionation can be achieved, not only for perioptic malignant tumors, but for benign lesions as well, because of the very low alpha/beta ratio of the optic system of 1.03  Gy. An increased single fraction equivalent dose of up to 10% for perioptic meningiomas and of more than 25% for malignant tumors can be reached with optimized hypofractionated stereotactic radiosurgery schedules.
Source: Journal of Radiation Oncology - Category: Cancer & Oncology Source Type: research
This article investigates a relatively concise and practical clinical classification system for clival chordomas and summarizes the clinical characteristics and operative key points of different clinical types. Here, 55 patients with clival chordomas treated through EEAs from 2012 to 2017 were retrospectively reviewed. Depending on the origin of the notochord and the growth pattern of the tumor, with our introduced Wang ’s line, these cases of clival chordoma were divided into types I–IV. There were 14 cases of type I-A, 7 cases of type I-B, 10 cases of type II, 10 cases of type III-A, 7 cases of type III-B, an...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research
Conditions:   Effect of Drugs;   Quality of Life;   Chordoma;   Advanced Cancer Intervention:   Drug: Anlotinib Hydrochloride Sponsors:   Peking University People's Hospital;   Peking University Shougang Hospital;   Peking University Third Hospital;   3Peking University First Hospital;   Beijing Jishuitan Hospital;   People's Liberation Army General Hospital (301);   Beijing Cancer Hospital;   Cancer In stitute and Hospit...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Effect of Drugs;   Quality of Life;   Chordoma;   Advanced Cancer Intervention:   Drug: Anlotinib Hydrochloride Sponsors:   Peking University People's Hospital;   Peking University Shougang Hospital;   Peking University Third Hospital;   Peking University First Hospital;   Beijing Jishuitan Hospital;   Chinese PLA General Hospital;   Beijing Cancer Hospital;   Cancer Institute and Hospital, Chinese Academy of Medical Sciences Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Effect of Drugs;   Quality of Life;   Chordoma;   Advanced Cancer Intervention:   Drug: Anlotinib Hydrochloride Sponsors:   Peking University People's Hospital;   Peking University Shougang Hospital;   Peking University Third Hospital;   3Peking University First Hospital;   Beijing Jishuitan Hospital;   People's Liberation Army General Hospital (301);   Beijing Cancer Hospital;   Cancer In stitute and Hospit...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractBackgroundChordoma is a rare refractory neoplasm that arises from the embryological remnants of the notochord, which is incurable using any multimodality therapy. Vascular endothelial growth factor (VEGF) is a potent activator of angiogenesis that is strongly associated with the tumor-immune microenvironment. These factors have not been elucidated for chordomas.MethodsTo evaluate the characteristics of vascular and tumor cells in chordoma, we first analyzed the expression of VEGF receptor (VEGFR) 1, VEGFR2, CD34, and Brachyury in a cell line and 54 tumor tissues. Patients with primary skull base chordomas were divi...
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
ConclusionDC patients exhibit significantly higher rates of both synchronous and metachronous metastases, as well as shorter overall survival rates compared to conventional chordoma. The relatively poor survival outcomes with conventional therapies indicate the need to study targeted therapies for the treatment of DC.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
ABSTRACT The aberrant activation of developmental processes triggers diverse cancer types. Chordoma is a rare, aggressive tumor arising from transformed notochord remnants. Several potentially oncogenic factors have been found to be deregulated in chordoma, yet causation remains uncertain. In particular, sustained expression of TBXT – encoding the notochord regulator protein brachyury – is hypothesized as a key driver of chordoma, yet experimental evidence is absent. Here, we employ a zebrafish chordoma model to identify the notochord-transforming potential of implicated genes in vivo. We find that Brachyury, i...
Source: DMM Disease Models and Mechanisms - Category: Biomedical Science Authors: Tags: Cancer, Rare diseases, Zebrafish as a Disease Model RESEARCH ARTICLE Source Type: research
The management of cranial chordomas is controversial. We provide a comprehensive review of the evolving patterns of care of cranial chordomas in the USA.
Source: Clinical Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
CONCLUSION: We have carried out an extensive measurement of H*(10) under different conditions. The shielding thickness of our PT facility is adequate to limit the dose to occupational worker and general public within the permissible stipulated limit. The data reported here can bridge the knowledge gap in ambient dose around PT facility and can also be used as a reference for any new and existing proton facility for inter comparison and validation. ADVANCES IN KNOWLEDGE: First extensive investigation of neutron and photon H*(10) around PT facility and can bridge the knowledge gap on ambient dose. PMID: 31287739 [P...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
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