Adrian von Witzleben1, Lukas T Goerttler1, Jochen Lennerz2, Stephanie Weissinger1, Marko Kornmann3, Regine Mayer-Steinacker4, Alexandra von Baer5, Markus Schultheiss5, Peter Möller6, Thomas F E Barth1. 1. Institute of Pathology, M23, University Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany. 2. Department of Pathology, Massachusetts General Hospital, Boston, USA. 3. Department of General and Visceral Surgery, University Ulm, Ulm, Germany. 4. Department of Internal Medicine III, University Ulm, Ulm, Germany. 5. Department of Trauma Surgery, University Ulm, Ulm, Germany. 6. Institute of Pathology, M23, University Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany. peter.moeller@uniklinik-ulm.de.
Abstract
PURPOSE: To establish a chordoma tissue cohort (n = 43) and to correlate localization, size, metastasis, residual disease (R-status), recurrences, histological subtype, matrix content, and Ki-67 proliferation index with patients' overall survival (OS). METHODS AND RESULTS: We used routine histopathology supplemented by immunohistochemistry. In our patient cohort (median age 69 years, range 17 to 84 years) the median OS was 8.25 years. 24 chordomas were localized in the sacrum, 6 in lumbar vertebrae, 7 in thoracic and cervical vertebrae, 5 were limited to the clivus, and one was localized in the nasal septum. Ten patients had metastases, with pulmonary, nodal, and hepatic involvement. 23 patients had recurrent disease. 23 chordomas were classified as 'not otherwise specified' (NOS). Besides NOS, we found the following differentiation patterns: renal cell cancer like in six cases, chondroid in four cases, hepatoid differentiation in three cases, and anaplastic morphology in six cases. Ki-67 index of ≥10 %, presence of metastasis, and the low content of extracellular matrix were statistically linked to poor OS (p < 0.05). The matrix-poor phenotype had a higher Ki-67 index (p < 0.05). Furthermore, presence of metastasis was associated with a higher Ki-67 index in the primary lesion, a positive resection margin, and multiple recurrences (p < 0.05 each). CONCLUSION: We propose to include these parameters in the final pathologic report of the resected chordoma.
PURPOSE: To establish a chordoma tissue cohort (n = 43) and to correlate localization, size, metastasis, residual disease (R-status), recurrences, histological subtype, matrix content, and Ki-67 proliferation index with patients' overall survival (OS). METHODS AND RESULTS: We used routine histopathology supplemented by immunohistochemistry. In our patient cohort (median age 69 years, range 17 to 84 years) the median OS was 8.25 years. 24 chordomas were localized in the sacrum, 6 in lumbar vertebrae, 7 in thoracic and cervical vertebrae, 5 were limited to the clivus, and one was localized in the nasal septum. Ten patients had metastases, with pulmonary, nodal, and hepatic involvement. 23 patients had recurrent disease. 23 chordomas were classified as 'not otherwise specified' (NOS). Besides NOS, we found the following differentiation patterns: renal cell cancer like in six cases, chondroid in four cases, hepatoid differentiation in three cases, and anaplastic morphology in six cases. Ki-67 index of ≥10 %, presence of metastasis, and the low content of extracellular matrix were statistically linked to poor OS (p < 0.05). The matrix-poor phenotype had a higher Ki-67 index (p < 0.05). Furthermore, presence of metastasis was associated with a higher Ki-67 index in the primary lesion, a positive resection margin, and multiple recurrences (p < 0.05 each). CONCLUSION: We propose to include these parameters in the final pathologic report of the resected chordoma.
Entities:
Keywords:
Chordoma; Histological parameters and subtyping; Overall survival
Authors: Brian P Walcott; Brian V Nahed; Ahmed Mohyeldin; Jean-Valery Coumans; Kristopher T Kahle; Manuel J Ferreira Journal: Lancet Oncol Date: 2012-02 Impact factor: 41.316
Authors: H Shimada; I M Ambros; L P Dehner; J Hata; V V Joshi; B Roald; D O Stram; R B Gerbing; J N Lukens; K K Matthay; R P Castleberry Journal: Cancer Date: 1999-07-15 Impact factor: 6.860
Authors: Youssef Yakkioui; Yasin Temel; David Creytens; Ali Jahanshahi; Ruth Fleischeuer; René G C Santegoeds; Jacobus J Van Overbeeke Journal: World Neurosurg Date: 2013-02-14 Impact factor: 2.104
Authors: Olaf Determann; Eva Hoster; German Ott; Heinz Wolfram Bernd; Christoph Loddenkemper; Martin Leo Hansmann; Thomas E F Barth; Michael Unterhalt; Wolfgang Hiddemann; Martin Dreyling; Wolfram Klapper Journal: Blood Date: 2007-12-12 Impact factor: 22.113
Authors: M A Weniger; K Pulford; S Gesk; S Ehrlich; A H Banham; L Lyne; J I Martin-Subero; R Siebert; M J S Dyer; P Möller; T F E Barth Journal: Leukemia Date: 2006-07-27 Impact factor: 11.528
Authors: J Bai; J Shi; S Zhang; C Zhang; Y Zhai; S Wang; M Li; C Li; P Zhao; S Geng; S Gui; L Jing; Y Zhang Journal: AJNR Am J Neuroradiol Date: 2020-05-07 Impact factor: 3.825
Authors: P Oikonomou; A Giatromanolaki; A K Tsaroucha; K Balaska; C H Tsalikidis; C H Nikolaou; M Pitiakoudis; C Simopoulos Journal: Hippokratia Date: 2019 Apr-Jun Impact factor: 0.471
Authors: William L Harryman; Jaime M C Gard; Kelvin W Pond; Skyler J Simpson; Lucas H Heppner; Daniel Hernandez-Cortes; Andrew S Little; Jennifer M Eschbacher; Anne E Cress Journal: Neoplasia Date: 2017-09-24 Impact factor: 5.715
Authors: Daniela Jäger; Thomas F E Barth; Silke Brüderlein; Angelika Scheuerle; Beate Rinner; Adrian von Witzleben; André Lechel; Patrick Meyer; Regine Mayer-Steinacker; Alexandra von Baer; Markus Schultheiss; Christian R Wirtz; Peter Möller; Kevin Mellert Journal: Sci Rep Date: 2017-05-17 Impact factor: 4.379