Results following surgical resection of recurrent chordoma of the spine: experience in a single institution
Results following surgical resection of recurrent chordoma of the spine: experience in a single institution
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DOI：
10.1186/s12957-020-02005-4
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发表时间：
2020-08-27
影响因子：
3.2
通讯作者：
Laohacharoensombat, Wichien
中科院分区：
文献类型：
--
作者：
Chanplakorn, Pongsthorn;Lertudomphonwanit, Thamrong;Laohacharoensombat, Wichien
背景 脊柱脊索瘤是一种低度恶性肿瘤，症状模糊、惰性。因此，几乎所有病例在诊断时都会遇到较大的肿瘤肿块，这使得整块切缘切除变得困难。由于其无情的性质和辅助治疗的难治性，复发性脊索瘤的挽救治疗非常具有挑战性。本研究的目的是报告脊柱脊索瘤手术切除后的肿瘤学结果。材料和方法对2003年至2018年期间在一家三级医疗中心接受手术治疗的连续10例复发性脊索瘤患者进行回顾性分析。结果 患者10例；本研究包括 4 名女性和 6 名男性。 8 名患者出现局部复发。复发发生在肌肉、周围软组织和剩余骨结构处。 2例患者发现远处转移。复发或转移的中位时间为首次手术后 30 个月。结论 为了预防复发，必须进行整块游离缘切除。应每 3 至 6 个月进行一次临床警惕和调查，以识别肿瘤复发，特别是在前 30 个月，此后每年一次。早期发现小肿块复发可能是进行整块无切缘切除以防止进一步复发的最佳机会。
Background Chordoma of the spine is a low-grade malignant tumor with vague and indolent symptoms; thus, large tumor mass is encountered at the time of diagnosis in almost cases and makes it difficult for en-bloc free-margin resection. Salvage therapy for recurrent chordoma is very challenging due to its relentless nature and refractory to adjuvant therapies. The aim of this present study was to report the oncologic outcome following surgical resection of chordoma of the spine. Materials and methods Retrospective review of 10 consecutive cases of recurrent chordoma patients who underwent surgical treatment between 2003 and 2018 at one tertiary-care center was conducted. Results There were 10 patients; 4 females and 6 males were included in this study. Eight patients had local recurrence. The recurrence was encountered at the muscle, surrounding soft tissue, and remaining bony structure. Distant metastases were found in 2 patients. The median time to recurrence or metastasis was 30 months after first surgery. Conclusion En-bloc free-margin resection is mandatory to prevent recurrence. The clinical vigilance and investigation to identify tumor recurrent should be performed every 3 to 6 months, especially in the first 30 months and annually thereafter. Detection of recurrent in early stage with a small mass may be the best chance to perform an en-bloc margin-free resection to prevent further recurrence.