Díaz-Castillejos A, Zottis-Grapiglia C, Rehder R, Borba LAB

Language: Spanish
References: 41
Page: 133-149
PDF size: 1591.41 Kb.

ABSTRACT

Introduction: Chordoma is an uncommon, slow-growing tumor, locally invasive and destructive, arising from notochordal remnants. It originates from skull base central portion, demonstrating different patterns of invasiveness, including duramater penetration and its spread through vascular structures, compromising its completely resection.
Objective: To analyze the different options of treatment, results, and complications.
Methods: Between 2002 and 2012, 31 patients presenting skull base chordomas were treated surgically at the Evangelico University Hospital of Curitiba, Curitiba-Brazil. The follow-up period was 1-72 months. All patients were evaluated by means of head CT and MRI. Surgical approaches were chosen for each specific case, aiming to obtain a tumor radical resection. Some patients were submitted to radiotherapy after surgical resection.
Results: Radical resection was performed in 81% of the patients. A five-year survival rate was 75%. Radical resection had a positive impact on the survival rate. The possibility to perform a radical resection depended on the tumor volume pre-operation and number of anatomic regions invaded. The sixth cranial nerve palsy and CSF fistula were the most common surgical complications.
Conclusions: The purpose of the surgical management treating skull base chordomas consists in performing radical resection using different types of surgical approaches, which implies an acceptable risk.

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