[Giant clivus chordomas. Are extensive surgeries really justified?].

Because of their location and biological behavior, clivus chordomas are tumors that still represent a great challenge, mainly when they have reached huge dimensions. In this paper we have selected the patients with the biggest clivus chordomas to analyze if they really can be helped with the current surgical procedures with the morbidity that it implies. Eleven patients with giant clivus chordomas were included. All of them were operated on following the recent criteria of Cranial Base Surgery. It was mainly analyzed, if the degree of the resection had any relation to the postoperative functional outcome and the disease-free survival time; it was also evaluated if there existed a correlation between the pathologic findings and the clinical course. It was possible to get a total resection in 8 patients and partial in 3. In all cases there was an evident improvement in their postoperative functional outcome, specially in those with complete resections. The disease-free survival time was also greater in the patients with more ample resections. There was not any correlation among the histologic variety of tumors (typical or chondroid) and the clinical prognosis.