Investigation of ectopic recurrent skull base and cervical chordomas: The Institut Curie's proton therapy center experience. (4th September 2015)

• Record Type: Journal Article
• Authors: Vogin, Guillaume; Calugaru, Valentin; Bolle, Stéphanie; George, Bernard; Oldrini, Guillaume; Habrand, Jean‐Louis; Mammar, Hamid; Dendale, Rémi; Salleron, Julia; Noël, Georges; Feuvret, Loïc
• Is Part Of: Head & neck. Volume 38(2016)Supplement 1
• Page Start: E1238
• Page End: E1246
• Publication Date: 2015-09-04
• Subjects: cervical and skull base chordomas -- proton therapy -- surgical pathway recurrence -- nodal recurrence -- neuraxial recurrence -- metastasis; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.24199
• Languages: English
• ISSNs: 1043-3074

Abstract

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. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1238–E1246, 2016