دورية أكاديمية
Clival chordomas: considerations after 16 years of endoscopic endonasal surgery
| العنوان: | Clival chordomas: considerations after 16 years of endoscopic endonasal surgery |
|---|---|
| المؤلفون: | ZOLI, MATTEO, Milanese, Laura, BONFATTI, ROCCO, Faustini Fustini, Marco, Marucci, Gianluca, TALLINI, GIOVANNI, ZENESINI, CORRADO, STURIALE, CARMELO, FRANK, GIORGIO, PASQUINI, ERNESTO, MAZZATENTA, DIEGO |
| المساهمون: | Zoli, Matteo, Milanese, Laura, Bonfatti, Rocco, Faustini Fustini, Marco, Marucci, Gianluca, Tallini, Giovanni, Zenesini, Corrado, Sturiale, Carmelo, Frank, Giorgio, Pasquini, Ernesto, Mazzatenta, Diego |
| سنة النشر: | 2018 |
| المجموعة: | IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: | CN = cranial nerve, CS = cavernous sinu, CSF leak, EEA = endoscopic endonasal approach, GTR = gross-total resection, ICA = internal carotid artery, PTR = partial tumor resection, QOL = quality of life, STR = subtotal resection, clivus chordoma, endoscopic endonasal approach, oncology, quality of life, surgical complication, surgical outcome, survival rate |
| الوصف: | OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter. Postoperative adjuvant therapies were considered. RESULTS Sixty-five patients (male/female ratio 1:0.9) were included in this study. The median age was 48 years (range 9-80 years). Gross-total resection (GTR) was achieved in 47 cases (58.7%). On univariate analysis, primary procedures (p = 0.001), location in the superior or middle third of the clivus (p = 0.043), extradural location (p = 0.035), and histology of conventional chordomas (p = 0.013) were associated with a higher rate of GTR. The complication rate was 15.1%, and there were no perioperative deaths. Most complications did not result in permanent sequelae and included 2 CSF leaks (2.5%), 5 transient cranial nerve VI palsies (6.2%), and 2 internal carotid artery injuries (2.5%), which were treated with coil occlusion of the internal carotid artery without neurological deficits. Three patients (3.8%) presented with complications resulting in permanent neurological deficits due to a postoperative hematoma (1.2%) causing a hemiparesis, and 2 permanent ophthalmoplegias (2.5%). Seventeen patients (26.2%) have died of tumor progression over the course of follow-up (median 52 months, range 7-159 months). Based on Kaplan-Meier analysis, the survival rate was 77% at 5 years and 57% at 10 years. On multivariate analysis, the extent of tumor ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | STAMPA |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28409727; info:eu-repo/semantics/altIdentifier/wos/WOS:000423820500001; volume:128; issue:2; firstpage:329; lastpage:338; numberofpages:10; journal:JOURNAL OF NEUROSURGERY; http://hdl.handle.net/11585/625147Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85041721487 |
| DOI: | 10.3171/2016.11.JNS162082 |
| الإتاحة: | https://doi.org/10.3171/2016.11.JNS162082Test http://hdl.handle.net/11585/625147Test |
| رقم الانضمام: | edsbas.DD8AD673 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3171/2016.11.JNS162082 |
|---|