Guillaume Vogin1, Valentin Calugaru2,3, Stéphanie Bolle4,3, Bernard George5, Guillaume Oldrini6, Jean-Louis Habrand7,3, Hamid Mammar2,3, Rémi Dendale2,3, Julia Salleron8, Georges Noël9, Loïc Feuvret3,10. 1. Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Nancy, France. 2. Department of Radiation Oncology, Institut Curie, Paris, France. 3. Protontherapy Center, Institut Curie, Orsay, France. 4. Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France. 5. Department of Neurosurgery, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Paris, France. 6. Department of Radiology, Institut de Cancérologie de Lorraine, Nancy, France. 7. Department of Radiation Oncology, Centre François Baclesse, Caen, France. 8. Department of Biostatistics, Institut de Cancérologie de Lorraine, Nancy, France. 9. Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France. 10. Department of Radiation Oncology, Hôpital La Pitié Salpétrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
Abstract
BACKGROUND: Cervical and skull base chordomas may relapse locally, marginally, or in ectopic sites (ie, surgical pathway, lymph nodes, prevertebral space, subdural space, or distant organs). METHODS: Among 371 patients treated between 1995 and 2010, we matched the initial dosimetry with the 3D imaging of recurrence and selected the patients with isolated ectopic recurrence. RESULTS: During our follow-up, we identified 13 patients who developed ectopic relapses (n = 18) in the form of lung metastasis (n = 2), axial dissemination (n = 6), nodal recurrence (n = 2), subcutaneous metastasis (n = 3), and/or seeding along the surgical pathway (n = 5). Despite treatment of these 13 patients with radiation, surgical interventions, and/or chemotherapy, we could only salvage 5 patients with recurrence in surgical pathway, whereas the remaining 8 patients succumbed to a poor prognosis. CONCLUSION: Our study emphasizes an urgent need for prediction and early diagnosis of ectopic relapses in patients with cervical and skull base chordoma to improve accuracy of their aggressive treatments.
BACKGROUND: Cervical and skull base chordomas may relapse locally, marginally, or in ectopic sites (ie, surgical pathway, lymph nodes, prevertebral space, subdural space, or distant organs). METHODS: Among 371 patients treated between 1995 and 2010, we matched the initial dosimetry with the 3D imaging of recurrence and selected the patients with isolated ectopic recurrence. RESULTS: During our follow-up, we identified 13 patients who developed ectopic relapses (n = 18) in the form of lung metastasis (n = 2), axial dissemination (n = 6), nodal recurrence (n = 2), subcutaneous metastasis (n = 3), and/or seeding along the surgical pathway (n = 5). Despite treatment of these 13 patients with radiation, surgical interventions, and/or chemotherapy, we could only salvage 5 patients with recurrence in surgical pathway, whereas the remaining 8 patients succumbed to a poor prognosis. CONCLUSION: Our study emphasizes an urgent need for prediction and early diagnosis of ectopic relapses in patients with cervical and skull base chordoma to improve accuracy of their aggressive treatments.
Authors: René G C Santegoeds; Mohammed Alahmari; Alida A Postma; Norbert J Liebsch; Damien Charles Weber; Hamid Mammar; Daniëlle B P Eekers; Yasin Temel Journal: Curr Oncol Date: 2022-03-28 Impact factor: 3.109