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Analysis of the Infiltrative Features of Chordoma: The Relationship Between Micro-Skip Metastasis and Postoperative Outcomes.
Akiyama, Toru; Ogura, Koichi; Gokita, Tabu; Tsukushi, Satoshi; Iwata, Shintaro; Nakamura, Tomoki; Matsumine, Akihiko; Yonemoto, Tsukasa; Nishida, Yoshihiro; Saita, Kazuo; Kawai, Akira; Matsumoto, Seiichi; Yamaguchi, Takehiko.
Afiliación
  • Akiyama T; Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan. toruakiyama827@jichi.ac.jp.
  • Ogura K; Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
  • Gokita T; Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Tsukushi S; Department of Orthopedic Surgery, Cancer Institute Hospital, Tokyo, Japan.
  • Iwata S; Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
  • Nakamura T; Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan.
  • Matsumine A; Department of Orthopaedic Surgery, Mie University Hospital, Mie, Japan.
  • Yonemoto T; Department of Orthopaedic Surgery, Mie University Hospital, Mie, Japan.
  • Nishida Y; Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan.
  • Saita K; Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Aichi, Japan.
  • Kawai A; Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
  • Matsumoto S; Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
  • Yamaguchi T; Department of Orthopedic Surgery, Cancer Institute Hospital, Tokyo, Japan.
Ann Surg Oncol ; 25(4): 912-919, 2018 Apr.
Article en En | MEDLINE | ID: mdl-29181683
BACKGROUND: Chordomas are very rare primary malignant bone tumors that arise commonly from the sacrum (50-60%) and clivus (25-35%). Chordomas have a high rate of recurrence. The authors confirmed a unique histologic infiltration pattern of chordomas that resembles a skip-metastatic lesion in normal tissue around tumor, which they named "micro-skip metastasis." This study aimed to examine the correlations between the clinicopathologic features of chordomas, including micro-skip metastasis, and the clinical outcomes, including overall survival, local recurrence-free survival, and distant metastasis-free survival. METHODS: The study analyzed histopathologic and clinical data from patients with sacral chordomas who underwent en bloc resection from July 1991 through July 2014. Cases with a minimum follow-up period shorter than 20 months after resection were excluded. Kaplan-Meier survival analyses with log-rank tests were performed for overall survival, metastasis-free survival, and recurrence-free survival. RESULTS: The study retrospectively reviewed 40 patients. The mean follow-up period was 98.2 months (range 22-297 months). The local recurrence rate was 41.3%. Micro-skip metastases, observed in 17 patients (42.5%), were associated with a significantly increased risk of local recurrence (p = 0.023) but not with overall survival or distant metastasis-free survival. Poorer overall survival was associated with histologic vascular invasion (p = 0.030) and a greater maximum tumor diameter (p = 0.050). CONCLUSIONS: The presence of micro-skip metastasis was associated with a higher rate of local recurrence. The maximum tumor diameter and the presence of histologic vascular invasion were associated with poorer overall survival.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Sacro / Cordoma / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Sacro / Cordoma / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article País de afiliación: Japón