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Major determinants of local control in primary chordomas at all sites include tumor size, extent of resection, quality of surgery, quality of RT (e.g. dose, volume, timing and dose inhomogeneity) and patient age [2, 7–9]. The experience of the treatment center may also play a role in the likelihood of recurrence.
Chordoma experts have developed detailed recommendations on the way chordoma should be diagnosed and treated. Learn more on the pages linked below.
13 Ιουν 2013 · Guidelines will help chordoma patients and their physicians make informed decisions that reflect the very latest standard of care. The National Comprehensive Cancer Network (NCCN) has published the first guidelines for the diagnosis, treatment, and follow-up care of chordoma patients.
26 Ιουλ 2018 · The gold standard treatment for chordomas of the mobile spine and sacrum is complete en bloc resection of the tumor with clean margins and postoperative external-beam radiation therapy. It provides the longest survival in most of the data. 8
As with chordomas in the skull base and mobile spine, the adequacy of resection margins has the greatest influence on prognosis, overall survival and risk of local recurrence [12,13,14,67,79], yet wide or marginal resections of sacral chordoma are achieved in only 40 – 55.6% of cases [8,13,14].
Sacral chordomas are rare low-to-intermediate grade malignant tumours, which arise from remnants of the embryonic notochord. This review explores prognostic factors in the management of sacral chordomas and provides guidance on the optimal treatment regimens based on the current literature.
23 Ιουλ 2021 · Key aspects in determining and executing the surgical approach for sacral chordomas include the rostral level of resection and degree of soft tissue extension or contamination. Rostral extension will imply the extent of neurologic sacrifice and the potential need for spinopelvic reconstruction.
