Chordoma of the mobile spine: Fifty years of experience

Stefano Boriani, Stefano Bandiera, Roberto Biagini, Patrizia Bacchini, Luca Boriani, Michele Cappuccio, Francois Chevalley, Alessandro Gasbarrini, Piero Picci, James N. Weinstein

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN.: A consecutive series of 52 chordomas of the mobile spine observed over a 50-year period includes a retrospective review of 15 cases treated prior to 1991 and a prospective group of 37 cases treated from 1991 to 2002. OBJECTIVES.: This series reviews epidemiologic issues as well as clinical patterns of spinal chordomas. We attempt to correlate tumor extent, treatment, and outcomes over time. SUMMARY OF BACKGROUND DATA.: Chordoma is the most frequent primary tumor of the mobile spine. Due to slow growth, both initial symptoms and recurrences after treatment arise later, making it difficult to evaluate the effectiveness of treatment protocols. METHODS.: A prospective series of 37 cases is compared with a retrospective group of 15 patients observed between 1954 and 1991. In the prospective study, all patients had imaging studies, and oncologic and surgical staging. When en bloc resection was not feasible, intralesional extracapsular excision was combined with radiation therapy. The prospective patients were clinically evaluated and imaged. Patients in the retrospective group were evaluated by chart and available images; of these, only one en bloc resection (intralesional margin) was performed. Survivors were all evaluated clinically and had radiographic studies. RESULTS.: Forty-eight patients were available for long-term follow-up. Four died due to post-operative complications, and six due to disease less than 2 years after treatment. Forty-two patients were followed over 2 years; 26 patients had over 5 years follow-up. All patients having radiation alone, intralesional excision, or a combination had recurrences in less than 2 years, and died in some cases after a long survival with symptomatic disease. Intralesional extracapsular excision with radiation had a high rate of recurrence (12 of 16 at average 30 months), but 3 patients are continuously disease-free (CDF) at mean 52 months and 5 are alive with disease at average 69 months (ranging 24 to 146). Twelve of 18 patients having en bloc resection are CDF at average 8 years (48 to 155 months). The remaining 6 recurred and of these 1 died. All of these (6) had been previously treated and/or had en bloc resections with contaminated margins. CONCLUSIONS.: The only treatment protocol associated with CDF at follow-up longer than 5 years is margin-free en bloc resection.

Original languageEnglish
Pages (from-to)493-503
Number of pages11
JournalSpine
Volume31
Issue number4
DOIs
Publication statusPublished - Feb 2006

Fingerprint

Chordoma
Spine
Clinical Protocols
Recurrence
Radiation
Survivors
Neoplasms
Radiotherapy
Prospective Studies

Keywords

  • Case series
  • Chordoma
  • Spine
  • Tumor

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Boriani, S., Bandiera, S., Biagini, R., Bacchini, P., Boriani, L., Cappuccio, M., ... Weinstein, J. N. (2006). Chordoma of the mobile spine: Fifty years of experience. Spine, 31(4), 493-503. https://doi.org/10.1097/01.brs.0000200038.30869.27

Chordoma of the mobile spine : Fifty years of experience. / Boriani, Stefano; Bandiera, Stefano; Biagini, Roberto; Bacchini, Patrizia; Boriani, Luca; Cappuccio, Michele; Chevalley, Francois; Gasbarrini, Alessandro; Picci, Piero; Weinstein, James N.

In: Spine, Vol. 31, No. 4, 02.2006, p. 493-503.

Research output: Contribution to journalArticle

Boriani, S, Bandiera, S, Biagini, R, Bacchini, P, Boriani, L, Cappuccio, M, Chevalley, F, Gasbarrini, A, Picci, P & Weinstein, JN 2006, 'Chordoma of the mobile spine: Fifty years of experience', Spine, vol. 31, no. 4, pp. 493-503. https://doi.org/10.1097/01.brs.0000200038.30869.27
Boriani, Stefano ; Bandiera, Stefano ; Biagini, Roberto ; Bacchini, Patrizia ; Boriani, Luca ; Cappuccio, Michele ; Chevalley, Francois ; Gasbarrini, Alessandro ; Picci, Piero ; Weinstein, James N. / Chordoma of the mobile spine : Fifty years of experience. In: Spine. 2006 ; Vol. 31, No. 4. pp. 493-503.
@article{fa95e619bdda4ab7a0c91ed15d048ea0,
title = "Chordoma of the mobile spine: Fifty years of experience",
abstract = "STUDY DESIGN.: A consecutive series of 52 chordomas of the mobile spine observed over a 50-year period includes a retrospective review of 15 cases treated prior to 1991 and a prospective group of 37 cases treated from 1991 to 2002. OBJECTIVES.: This series reviews epidemiologic issues as well as clinical patterns of spinal chordomas. We attempt to correlate tumor extent, treatment, and outcomes over time. SUMMARY OF BACKGROUND DATA.: Chordoma is the most frequent primary tumor of the mobile spine. Due to slow growth, both initial symptoms and recurrences after treatment arise later, making it difficult to evaluate the effectiveness of treatment protocols. METHODS.: A prospective series of 37 cases is compared with a retrospective group of 15 patients observed between 1954 and 1991. In the prospective study, all patients had imaging studies, and oncologic and surgical staging. When en bloc resection was not feasible, intralesional extracapsular excision was combined with radiation therapy. The prospective patients were clinically evaluated and imaged. Patients in the retrospective group were evaluated by chart and available images; of these, only one en bloc resection (intralesional margin) was performed. Survivors were all evaluated clinically and had radiographic studies. RESULTS.: Forty-eight patients were available for long-term follow-up. Four died due to post-operative complications, and six due to disease less than 2 years after treatment. Forty-two patients were followed over 2 years; 26 patients had over 5 years follow-up. All patients having radiation alone, intralesional excision, or a combination had recurrences in less than 2 years, and died in some cases after a long survival with symptomatic disease. Intralesional extracapsular excision with radiation had a high rate of recurrence (12 of 16 at average 30 months), but 3 patients are continuously disease-free (CDF) at mean 52 months and 5 are alive with disease at average 69 months (ranging 24 to 146). Twelve of 18 patients having en bloc resection are CDF at average 8 years (48 to 155 months). The remaining 6 recurred and of these 1 died. All of these (6) had been previously treated and/or had en bloc resections with contaminated margins. CONCLUSIONS.: The only treatment protocol associated with CDF at follow-up longer than 5 years is margin-free en bloc resection.",
keywords = "Case series, Chordoma, Spine, Tumor",
author = "Stefano Boriani and Stefano Bandiera and Roberto Biagini and Patrizia Bacchini and Luca Boriani and Michele Cappuccio and Francois Chevalley and Alessandro Gasbarrini and Piero Picci and Weinstein, {James N.}",
year = "2006",
month = "2",
doi = "10.1097/01.brs.0000200038.30869.27",
language = "English",
volume = "31",
pages = "493--503",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Chordoma of the mobile spine

T2 - Fifty years of experience

AU - Boriani, Stefano

AU - Bandiera, Stefano

AU - Biagini, Roberto

AU - Bacchini, Patrizia

AU - Boriani, Luca

AU - Cappuccio, Michele

AU - Chevalley, Francois

AU - Gasbarrini, Alessandro

AU - Picci, Piero

AU - Weinstein, James N.

PY - 2006/2

Y1 - 2006/2

N2 - STUDY DESIGN.: A consecutive series of 52 chordomas of the mobile spine observed over a 50-year period includes a retrospective review of 15 cases treated prior to 1991 and a prospective group of 37 cases treated from 1991 to 2002. OBJECTIVES.: This series reviews epidemiologic issues as well as clinical patterns of spinal chordomas. We attempt to correlate tumor extent, treatment, and outcomes over time. SUMMARY OF BACKGROUND DATA.: Chordoma is the most frequent primary tumor of the mobile spine. Due to slow growth, both initial symptoms and recurrences after treatment arise later, making it difficult to evaluate the effectiveness of treatment protocols. METHODS.: A prospective series of 37 cases is compared with a retrospective group of 15 patients observed between 1954 and 1991. In the prospective study, all patients had imaging studies, and oncologic and surgical staging. When en bloc resection was not feasible, intralesional extracapsular excision was combined with radiation therapy. The prospective patients were clinically evaluated and imaged. Patients in the retrospective group were evaluated by chart and available images; of these, only one en bloc resection (intralesional margin) was performed. Survivors were all evaluated clinically and had radiographic studies. RESULTS.: Forty-eight patients were available for long-term follow-up. Four died due to post-operative complications, and six due to disease less than 2 years after treatment. Forty-two patients were followed over 2 years; 26 patients had over 5 years follow-up. All patients having radiation alone, intralesional excision, or a combination had recurrences in less than 2 years, and died in some cases after a long survival with symptomatic disease. Intralesional extracapsular excision with radiation had a high rate of recurrence (12 of 16 at average 30 months), but 3 patients are continuously disease-free (CDF) at mean 52 months and 5 are alive with disease at average 69 months (ranging 24 to 146). Twelve of 18 patients having en bloc resection are CDF at average 8 years (48 to 155 months). The remaining 6 recurred and of these 1 died. All of these (6) had been previously treated and/or had en bloc resections with contaminated margins. CONCLUSIONS.: The only treatment protocol associated with CDF at follow-up longer than 5 years is margin-free en bloc resection.

AB - STUDY DESIGN.: A consecutive series of 52 chordomas of the mobile spine observed over a 50-year period includes a retrospective review of 15 cases treated prior to 1991 and a prospective group of 37 cases treated from 1991 to 2002. OBJECTIVES.: This series reviews epidemiologic issues as well as clinical patterns of spinal chordomas. We attempt to correlate tumor extent, treatment, and outcomes over time. SUMMARY OF BACKGROUND DATA.: Chordoma is the most frequent primary tumor of the mobile spine. Due to slow growth, both initial symptoms and recurrences after treatment arise later, making it difficult to evaluate the effectiveness of treatment protocols. METHODS.: A prospective series of 37 cases is compared with a retrospective group of 15 patients observed between 1954 and 1991. In the prospective study, all patients had imaging studies, and oncologic and surgical staging. When en bloc resection was not feasible, intralesional extracapsular excision was combined with radiation therapy. The prospective patients were clinically evaluated and imaged. Patients in the retrospective group were evaluated by chart and available images; of these, only one en bloc resection (intralesional margin) was performed. Survivors were all evaluated clinically and had radiographic studies. RESULTS.: Forty-eight patients were available for long-term follow-up. Four died due to post-operative complications, and six due to disease less than 2 years after treatment. Forty-two patients were followed over 2 years; 26 patients had over 5 years follow-up. All patients having radiation alone, intralesional excision, or a combination had recurrences in less than 2 years, and died in some cases after a long survival with symptomatic disease. Intralesional extracapsular excision with radiation had a high rate of recurrence (12 of 16 at average 30 months), but 3 patients are continuously disease-free (CDF) at mean 52 months and 5 are alive with disease at average 69 months (ranging 24 to 146). Twelve of 18 patients having en bloc resection are CDF at average 8 years (48 to 155 months). The remaining 6 recurred and of these 1 died. All of these (6) had been previously treated and/or had en bloc resections with contaminated margins. CONCLUSIONS.: The only treatment protocol associated with CDF at follow-up longer than 5 years is margin-free en bloc resection.

KW - Case series

KW - Chordoma

KW - Spine

KW - Tumor

UR - http://www.scopus.com/inward/record.url?scp=33644838929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644838929&partnerID=8YFLogxK

U2 - 10.1097/01.brs.0000200038.30869.27

DO - 10.1097/01.brs.0000200038.30869.27

M3 - Article

C2 - 16481964

AN - SCOPUS:33644838929

VL - 31

SP - 493

EP - 503

JO - Spine

JF - Spine

SN - 0362-2436

IS - 4

ER -