The sacral chordoma margin

被引：38

作者：

Radaelli, S. ^{[1
]}

Fossati, P. ^{[2
]}

Stacchiotti, S. ^{[3
]}

Akiyama, T. ^{[4
]}

Asencio, J. M. ^{[5
,6
]}

Bandiera, S. ^{[7
]}

Boglione, A. ^{[8
]}

Boland, P. ^{[9
]}

Bolle, S. ^{[10
]}

Bruland, O. ^{[11
,12
]}

Brunello, A. ^{[13
]}

Bruzzi, P. ^{[14
]}

Campanacci, D. ^{[15
]}

Cananzi, F. ^{[16
]}

Capanna, R. ^{[17
]}

Casadei, R. ^{[18
]}

Cordoba, A. ^{[19
]}

Court, C. ^{[20
]}

Dei Tos, A. P. ^{[21
,22
]}

DeLaney, T. F. ^{[23
]}

De Paoli, A. ^{[24
]}

De Pas, T. M. ^{[25
]}

Desai, A. ^{[26
]}

Di Brina, L. ^{[27
]}

Donati, D. M. ^{[18
]}

Fabbri, N. ^{[9
]}

Fiore, M. R. ^{[28
]}

Frezza, A. ^{[3
]}

Gambarotti, M. ^{[29
]}

Gasbarrini, A. ^{[7
]}

Georg, P. ^{[2
]}

Grignani, G. ^{[30
]}

Hindi, N. ^{[31
]}

Hug, E. B. ^{[2
]}

Jones, R. ^{[32
,33
]}

Kawai, A. ^{[34
]}

Krol, A. D. ^{[35
]}

Le Grange, F. ^{[36
,37
]}

Luzzati, A. ^{[38
]}

Marquina, G. ^{[39
]}

Martin-Benlloch, J. A. ^{[40
]}

Mazzocco, K. ^{[41
]}

Navarria, F. ^{[24
]}

Navarria, P. ^{[27
]}

Parchi, P. D. ^{[17
]}

Patel, S. ^{[42
]}

Pennacchioli, E. ^{[43
]}

Petrongari, M. G. ^{[44
]}

Picci, P. ^{[45
]}

Pollock, R. ^{[46
]}

机构：

[1] Fdn IRCCS Ist Nazl Tumori, Dept Surg, Via Giacomo Venezian 1, I-20133 Milan, Italy

[2] MedAustron Ion Therapy Ctr, Wiener Neustadt, Austria

[3] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol, Milan, Italy

[4] Jichi Med Univ, Saitama Med Ctr, Dept Orthopead Surg, Saitama, Japan

[5] Hosp Gen Univ Gregorio Maranon, Gen Surg Dept 3, Madrid, Spain

[6] Hosp Gen Univ Gregorio Maranon, Liver Transplant Unit, Madrid, Spain

[7] IRCCS Ist Ortoped Rizzoli, Dept Oncol & Degenerat Spine Surg, Bologna, Italy

[8] Osped Humanitas, Med Oncol Unit, Turin, Italy

[9] Mem Sloan Kettering Canc Ctr, Dept Surg, Orthoped Serv, 1275 York Ave, New York, NY 10021 USA

[10] Gustave Roussy Canc Campus, Dept Radiotherapie, Villejuif, France

[11] Univ Oslo, Inst Clin Med, Oslo, Norway

[12] Oslo Univ Hosp, Norwegian Radium Hosp, Dept Oncol, Oslo, Norway

[13] Ist Oncol Veneto IOV IRCCS, Dept Clin & Expt Oncol, Med Oncol Unit 1, Padua, Italy

[14] AOU San Martino IST, IRCCS, Dipartimento Epidemiol Clin, Genoa, Italy

[15] Azienda Osped Univ Careggi, Dept Orthoped Oncol, Florence, Toscana, Italy

[16] Humanitas Clin & Res Ctr, Surg Oncol Unit, Rozzano, Italy

[17] Univ Pisa, Dept Translat Res & New Technol Med & Surg, Orthoped Div 1, Pisa, Italy

[18] Univ Bologna, Dept Orthoped, Ist Ortoped Rizzoli, Bologna, Italy

[19] Oscar Lambret Comprehens Canc Ctr, Dept Radiotherapy, Lille, France

[20] Univ Paris Sud Orsay, Bicetre Univ Hosp, AP HP Paris, Orthopaed & Traumatol Dept,Spine & Tumor Unit, Orsay, France

[21] Treviso Gen Hosp, Dept Pathol & Mol Genet, Treviso, Italy

[22] Univ Padua, Sch Med, Dept Med, Padua, Italy

[23] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USA

[24] Natl Canc Inst, Ctr Riferimento Oncol, Dept Radiat Oncol, Aviano, Italy

[25] European Inst Oncol IRCCS, IEO, Div Med Oncol Melanoma & Sarcoma, Milan, Italy

[26] NHS Fdn Trust, Univ Hosp Birmingham, Midlands Abdominal & Retroperitoneal Sarcoma Unit, Dept Sarcoma & Gen Surg, Birmingham, W Midlands, England

[27] Radiotherapy & Radiosurg Humanitas Clin & Res Ctr, Milan, Italy

[28] Natl Ctr Oncol Hadrontherapy CNAO Pavia, Radiotherapy Unit, Pavia, Italy

[29] IRCCS Rizzoli Orthopaed Inst, Dept Pathol, Bologna, Italy

[30] Ist Ricovero & Cura Carattere Sci IRCCS, Ist Candiolo Fdn Piemonte Oncol, Med Oncol Sarcoma Unit, Candiolo, Italy

[31] Hosp Univ Virgen del Rocio, Med Oncol Dept, Inst Biomed IBIS, Seville, Spain

[32] Royal Marsden Hosp, London, England

[33] Inst Canc Res, London, England

[34] Natl Canc Ctr, Dept Musculoskeletal Oncol, Tokyo, Japan

[35] Leiden Univ, Med Ctr, Dept Radiat Oncol, Leiden, Netherlands

[36] Univ Coll London Hosp NHS Fdn Trust, London, England

[37] London Sarcoma Serv, London, England

[38] IRCCS Ist Ortoped Galeazzi, Ctr Chirurg Ortoped Oncol & Ricostrutt Rachide, Milan, Italy

[39] Hosp Clin San Carlos, Dept Med Oncol, Madrid, Spain

[40] Hosp Clin Univ Valencia, Dept Orthopaed Surg, Valencia, Spain

[41] Univ Milan, European Inst Oncol, Dept Oncol & Hematooncol, Appl Res Div Cognit & Psychol Sci, Milan, Lombardia, Italy

[42] Univ Texas MD Anderson Canc Ctr, Dept Sarcoma Med Oncol, Div Canc Med, Houston, TX 77030 USA

[43] European Inst Oncol, Div Melanoma Soft Tissue Sarcomas & Rare Tumors, Milan, Italy

[44] Regina Elena Inst Canc Res, Dept Radiat Oncol, Rome, Italy

[45] IRCCS Ist Ortoped Rizzoli, Lab Expt Oncol, Bologna, Italy

[46] Royal Natl Orthopaed Hosp NHS Trust, Brockley Hill, Stanmore, Middx, England

[47] Ist Ric Farmacol Mario Negri IRCCS, Dept Oncol, Lab Methodol Clin Res, Milan, Italy

[48] Fdn IRCCS Ist Nazl Tumori, Dept Radiat Therapy, Milan, Italy

[49] Med Univ Graz, Dept Orthopaed & Trauma, Graz, Austria

[50] Maria Sklodowska Curie Inst Oncol Ctr, Dept Radiotherapy 1, Warsaw, Poland

来源：

EJSO | 2020年 / 46卷 / 08期

关键词：

Sacral chordoma; Surgical margins; Surgery; Radiation therapy; CARBON ION RADIOTHERAPY; DOSE PHOTON/PROTON RADIOTHERAPY; EN-BLOC SACRECTOMY; MOBILE SPINE; PROGNOSTIC-FACTORS; RADIATION-THERAPY; PROTON THERAPY; OPERATIVE MANAGEMENT; FUNCTIONAL OUTCOMES; SURGICAL-TREATMENT;

D O I：

10.1016/j.ejso.2020.04.028

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: Aim of the manuscript is to discuss how to improve margins in sacral chordoma. Background: Chordoma is a rare neoplasm, arising in half cases from the sacrum, with reported local failure in >50% after surgery. Methods: A multidisciplinary meeting of the "Chordoma Global Consensus Group" was held in Milan in 2017, focusing on challenges in defining and achieving optimal margins in chordoma with respect to surgery, definitive particle radiation therapy (RT) and medical therapies. This review aims to report on the outcome of the consensus meeting and to provide a summary of the most recent evidence in this field. Possible new ways forward, including on-going international clinical studies, are discussed. Results: En-bloc tumor-sacrum resection is the cornerstone of treatment of primary sacral chordoma, aiming to achieve negative microscopic margins. Radical definitive particle therapy seems to offer a similar outcome compared to surgery, although confirmation in comparative trials is lacking; besides there is still a certain degree of technical variability across institutions, corresponding to different fields of treatment and different tumor coverage. To address some of these questions, a prospective, randomized international study comparing surgery versus definitive high-dose RT is ongoing. Available data do not support the routine use of any medical therapy as (neo)adjuvant/cytoreductive treatment. Conclusion: Given the significant influence of margins status on local control in patients with primary localized sacral chordoma, the clear definition of adequate margins and a standard local approach across institutions for both surgery and particle RT is vital for improving the management of these patients. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：1415 / 1422

页数：8

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