Long-term outcome of primary clival chordomas: a single-center retrospective study with an emphasis on the timing of recurrences based on the primary treatment
CONCLUSIONS: In this study, younger age, maximal safe resection, and radiation therapy were important factors for longer PFS in patients with primary clival chordomas. Preventing recurrences played a crucial role in achieving longer OS.PMID:38691852 | DOI:10.3171/2024.2.FOCUS23924 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Sukwoo Hong Yuki Shinya Anita Mahajan Nadia N Laack Erin K O'Brien Janalee K Stokken Jeffrey R Janus Aditya Raghunathan Michael J Link Jamie J Van Gompel Source Type: research

The burden of skull base chordomas: insights from a meta-analysis of observational studies
CONCLUSIONS: The results of this comprehensive meta-analysis highlight the tremendous impact of GTR and adjuvant PBRT on improving OS and PFS of patients harboring skull base chordomas, with better survival rates demonstrated for patients with chondroid tumors. Even in experienced hands, the rate of surgical morbidity remains high. Proper management in high-volume centers is mandatory to reach the expected resection goal at the first surgical attempt and to reduce surgical morbidity. The introduction of the endoscopic endonasal approach was related to improved surgical and functional outcomes.PMID:38691853 | DOI:10.3171/20...
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Giorgio Fiore Edoardo Porto Giulio A Bertani Hani J Marcus Andrea Saladino Gustavo Pradilla Francesco DiMeco Marco Locatelli Source Type: research

Quality of life in chordoma survivors: results from the Chordoma Foundation Survivorship Survey
CONCLUSIONS: The authors' findings suggest that younger survivors, female survivors, and survivors currently undergoing treatment for chordoma are at high risk for adverse QOL outcomes. Additionally, although nearly half of the participants reported a FCR, very few reported having adequate emotional/cognitive care. These findings may be useful in identifying specific groups of chordoma survivors vulnerable to QOL challenges and bring to light the need to expand care to meet the QOL needs for these patients.PMID:38691854 | DOI:10.3171/2024.2.FOCUS2410 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Adrian E Jimenez Kyle V Cicalese Miguel A Jimenez Sachiv Chakravarti Cathleen C Kuo Shannon Lozinsky Joseph H Schwab Sasha E Knowlton Nicholas R Rowan Debraj Mukherjee Source Type: research

Stereotactic radiosurgery in the management of skull base chordomas: a comprehensive systematic review and meta-analysis
CONCLUSIONS: This systematic review provides evidence on the safety and effectiveness of radiosurgery in the management of skull base chordomas. Local tumor control was achieved in the majority of patients treated with SRS. Various baseline characteristics and SRS features have been analyzed to identify modifying factors for each outcome to provide a framework for informed decision-making when managing these patients.PMID:38691855 | DOI:10.3171/2024.2.FOCUS249 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Seyed Farzad Maroufi Mohammad Sadegh Fallahi Mohammadmahdi Sabahi Seyede Parmis Maroufi Jason P Sheehan Source Type: research

A comparison of endoscopic endonasal versus open approaches for skull base chordoma: a comprehensive National Cancer Database analysis
CONCLUSIONS: The endoscopic endonasal approach has been increasingly utilized over time and touts noninferiority with respect to safety and efficacy with a marked improvement in LOS, which carries substantial implications for both healthcare costs and enhanced patient recovery. Future prospective studies are necessary to further delineate trends and surgical outcomes for skull base chordoma.PMID:38691856 | DOI:10.3171/2024.2.FOCUS23933 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Justin M Soffer Ruben Ulloa Sonja Chen Ryan S Ziltzer Vijay A Patel Sean P Polster Source Type: research

The utility of inflammatory biomarkers in predicting overall survival and recurrence in skull base chordoma
CONCLUSIONS: The routine assessment of inflammatory biomarkers such as NLR and SIRI could have prognostic value in postresection SBC patients.PMID:38691858 | DOI:10.3171/2024.2.FOCUS2421 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Meagan Hoppe Zachary C Gersey Nallammai Muthiah Hussein M Abdallah Tritan Plute Hussam Abou-Al-Shaar Eric W Wang Carl H Snyderman Georgios A Zenonos Paul A Gardner Source Type: research

Supramarginal resection of skull base chordomas: proof of concept and preliminary outcomes
CONCLUSIONS: In select cases, SMR of SBC appears to be feasible and safe. Larger cohorts and longer follow-up evaluations are necessary to explore the benefit of SMR and individualized postoperative radiation therapy on progression-free survival.PMID:38691859 | DOI:10.3171/2024.2.FOCUS23909 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Jonathan Rychen Felipe Constanzo Yuanzhi Xu Thomas M Johnstone Alix Bex Mariano Rinaldi Christine K Lee Juan C Fernandez-Miranda Source Type: research

Unraveling molecular advancements in chordoma tumorigenesis and treatment response: a review of scientific discoveries and clinical implications
Neurosurg Focus. 2024 May;56(5):E18. doi: 10.3171/2024.2.FOCUS2417.ABSTRACTChordomas are tumors thought to originate from notochordal remnants that occur in midline structures from the cloves of the skull base to the sacrum. In adults, the most common location is the sacrum, followed by the clivus and then mobile spine, while in children a clival origin is most common. Most chordomas are slow growing. Clinical presentation of chordomas tend to occur late, with local invasion and large size often complicating surgical intervention. Radiation therapy with protons has been proven to be an effective adjuvant therapy. Unfortuna...
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Michael C Jin Ian D Connolly Karthik Ravi Daniel G Tobert Shannon M MacDonald John H Shin Source Type: research

Introduction. Chordoma: updates and advances
Neurosurg Focus. 2024 May;56(5):E1. doi: 10.3171/2024.3.FOCUS23735.NO ABSTRACTPMID:38691861 | DOI:10.3171/2024.3.FOCUS23735 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Paul A Gardner Sebastien Froelich Ziya L Gokaslan Shannon M MacDonald Maria Peris Celda Shaan M Raza Georgios A Zenonos Source Type: research

Optimizing radiotherapy strategies for skull base chordoma: a comprehensive meta-analysis and systematic review of treatment modalities and outcomes
CONCLUSIONS: The analysis highlights the finding that particle-based modalities like proton beam radiotherapy and carbon ion radiotherapy are the most effective radiation therapies available for the treatment of SBC. Furthermore, it reinforces the idea that surgery followed by radiotherapy constitutes the standard treatment.PMID:38691862 | DOI:10.3171/2024.2.FOCUS2413 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Lucca B Palavani Pedro Borges Filipi Fim Andre ão Jordana Borges S ávio Batista Leonardo B Oliveira M árcio Yuri Ferreira Pedro C Abrah ão Reis Julia Pontes Herika Negri Andre Beer-Furlan Chandan Krishna Raphael Bertani Marcio S Rassi Source Type: research

Multidisciplinary surgical considerations for en bloc resection of sacral chordoma: review of recent advances and a contemporary single-center series
CONCLUSIONS: The modern management of sacral chordoma involves a multidisciplinary team of surgeons and intraoperative technologies to minimize surgical morbidity while optimizing oncological outcomes through en bloc resection. Most cases present with lower sacral tumors not requiring instrumentation, but stabilizing instrumentation and lumbosacral reconstruction are often required in upper sacral and lumbosacral cases. Among efforts to minimize wound-related complications, musculocutaneous flap closure stands out as an evidence-based measure that may mitigate risk.PMID:38691863 | DOI:10.3171/2024.2.FOCUS23926 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Christian Schroeder Weston C de Lomba Owen P Leary Rafael De la Garza Ramos Julia S Gillette Thomas J Miner Albert S Woo Jared S Fridley Ziya L Gokaslan Patricia L Zadnik Sullivan Source Type: research

Proton versus photon adjuvant radiotherapy: a multicenter comparative evaluation of recurrence following spinal chordoma resection
CONCLUSIONS: Following resection, adjuvant proton therapy was associated with a lower risk of chordoma recurrence compared with photon therapy. The described machine learning models were able to predict tumor progression based on the extent of tumor resection and adjuvant radiotherapy modality used.PMID:38691864 | DOI:10.3171/2024.2.FOCUS23927 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Abdul Karim Ghaith Ryan Nguyen Victor Gabriel El-Hajj Alaa Montaser Gaetano De Biase Krishnan Ravindran Carlos Perez-Vega Seung Jin Lee Asmina Dominari Umberto Battistin Paola Su árez-Meade Charbel Moussalem Naresh P Patel Maziyar A Kalani Michelle J Cla Source Type: research

Characterizing the presentation, management, and clinical outcomes of patients with intradural spinal chordomas: a systematic review
CONCLUSIONS: Treatment of intradural spinal chordomas primarily involves resection and radiotherapy. A significant challenge and complication in management is spinal tumor seeding after resection, with 9 studies proposing seeding as a mechanism of tumor metastasis in 11 cases. Factors such as tumor size, Ki-67 positivity, and distant metastasis may correlate with worse outcomes and demonstrate potential as prognostic indicators for intradural spinal chordomas. Further research is needed to improve understanding of this tumor and develop optimal treatment paradigms for these patients.PMID:38691865 | DOI:10.3171/2024.2.FOCUS...
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Max A Saint-Germain Patrick Kramer Carly Weber-Levine Kelly Jiang Abdel-Hameed Al-Mistarehi Kristin J Redmond Sang H Lee Chetan Bettegowda Nicholas Theodore Daniel Lubelski Source Type: research

Anatomical determinants of occipitocervical fusion in skull base chordoma resection: a systematic review of the literature with illustrative cases
CONCLUSIONS: Unilateral total condylectomy, 50% bilateral condylectomy, and resection of the medial atlantoaxial joint elements were the most frequently described independent predictors of OC fusion in skull base chordoma resection. Additionally, consistent with the occipital condyle harboring a significantly thicker joint capsule at its posterolateral aspect, an anterior midline approach seems to tolerate a greater degree of condylar resection (75%) than a lateral transcranial approach (50%-70%) prior to generating OC instability.PMID:38691866 | DOI:10.3171/2024.3.FOCUS248 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Danielle Golub Alexander F K üffer Shimon Garrel Sara Zandpazandi Joshua D McBriar Siddhi Modi Kyriakos Papadimitriou Peter D Costantino Daniel M Sciubba Amir R Dehdashti Source Type: research

The role of systemic therapy in advanced skull base chordomas: overview of the current state and the MD Anderson protocol
Neurosurg Focus. 2024 May;56(5):E15. doi: 10.3171/2024.2.FOCUS2416.ABSTRACTThe role of systemic therapy in primary or advanced and metastatic chordoma has been traditionally limited because of the inherent resistance to cytotoxic therapies and lack of specific or effective therapeutic targets. Despite resection and adjuvant radiation therapy, local recurrence rates in clival chordoma remain high and the risk of systemic metastases is not trivial, leading to significant morbidity and mortality. Recently, molecular targeted therapies (MTTs) and immune checkpoint inhibitors (ICIs) have emerged as promising therapeutic avenues...
Source: Neurosurgical Focus - May 1, 2024 Category: Neurosurgery Authors: Matei A Banu Shaan M Raza Misha Amini Scott Seaman Franco Rubino Rita Snyder Shreyaskumar Patel Franco DeMonte Anthony P Conley Source Type: research