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A multidisciplinary team approach to skull base chordomas.
H A Crockard1, T Steel, N Plowman
1Department of Surgical Neurology, The National Hospital for Neurology and Neurosurgery, London, United Kingdom. A.Crockard@ion.ucl.ac.uk
Journal of Neurosurgery
|January 10, 2002
Summary
Maximum surgical removal and radiation therapy improve long-term survival for skull base chordomas. Early, complete tumor resection offers the best prognosis, minimizing complications and mortality in these rare bone tumors.
Area of Science:
- Neurosurgery
- Oncology
- Radiotherapy
Background:
- Skull base chordomas are rare, slow-growing tumors.
- Long-term management requires a multidisciplinary approach.
Purpose of the Study:
- To describe a protocol for long-term care of skull base chordomas.
- To analyze outcomes of surgical and radiation treatment.
Main Methods:
- Retrospective review of 42 patients treated between 1986-1998.
- Maximum surgical cytoreduction followed by photon radiation therapy.
- Assessment of tumor growth using MRI, immunostaining, and Ki67 labeling index.
Main Results:
- Greatest extent of tumor removal during the first operation correlated with the best outcomes.
- No mortality in first-time surgeries; 7.1% mortality in subsequent operations.
- 5- and 10-year survival rates were 77% and 69%, respectively.
Conclusions:
- This study provides insights into managing skull base chordomas.
- Techniques enhancing survival and prognostic studies are crucial.
- Early, aggressive surgical resection is key to favorable outcomes.