Current treatment strategy for newly diagnosed chordoma of the mobile spine and sacrum: results of an international survey

Nicolas Dea, Charles G. Fisher, Jeremy J. Reynolds, Joseph Schwab, Laurence D. Rhines, Ziya L. Gokaslan, Chetan Bettegowda, Arjun Sahgal, Aron Lazary, Alessandro Luzzati, Stefano Boriani, Alessandro Gasbarrini, Ilya Laufer, R Charest-Morin, F Wei, W Teixeira, Niccole M. Germscheid, Francis J. Hornicek, Thomas F DeLaney, John H. ShinAOSpine Knowledge Forum Tumor

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE
The purpose of this study was to investigate the spectrum of current treatment protocols for managing newly diagnosed chordoma of the mobile spine and sacrum.

METHODS
A survey on the treatment of spinal chordoma was distributed electronically to members of the AOSpine Knowledge Forum Tumor, including neurosurgeons, orthopedic surgeons, and radiation oncologists from North America, South America, Europe, Asia, and Australia. Survey participants were pre-identified clinicians from centers with expertise in the treatment of spinal tumors. The suvey responses were analyzed using descriptive statistics.

RESULTS
Thirty-nine of 43 (91%) participants completed the survey. Most (80%) indicated that they favor en bloc resection without preoperative neoadjuvant radiation therapy (RT) when en bloc resection is feasible with acceptable morbidity. The main area of disagreement was with the role of postoperative RT, where 41% preferred giving RT only if positive margins were achieved and 38% preferred giving RT irrespective of margin status. When en bloc resection would result in significant morbidity, 33% preferred planned intralesional resection followed by RT, and 33% preferred giving neoadjuvant RT prior to surgery. In total, 8 treatment protocols were identified: 3 in which en bloc resection is feasible with acceptable morbidity and 5 in which en bloc resection would result in significant morbidity.

CONCLUSIONS
The results confirm that there is treatment variability across centers worldwide for managing newly diagnosed chordoma of the mobile spine and sacrum. This information will be used to design an international prospective cohort study to determine the most appropriate treatment strategy for patients with spinal chordoma.
Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 2019

Keywords

  • chordoma
  • mobile spine
  • oncology
  • radiation therapy
  • sacrum
  • treatment strategy

Fingerprint Dive into the research topics of 'Current treatment strategy for newly diagnosed chordoma of the mobile spine and sacrum: results of an international survey'. Together they form a unique fingerprint.

Cite this