Spinal chordomas--results of treatment over a 17-year period.
Among a series of 511 spinal tumours treated in the Department of Neurosurgery at the Nordstadt Hospital in Hannover, Germany, between September 1977 and August 1994, 23 operations for spinal chordomas in 9 patients (3 females, 6 males) were performed. After an average period of 7 +/- 12 months (2 weeks to 5 years) patients presented at an average age of 45 +/- 17 years with pain (68%), gait ataxia (14%), motor weakness (9%) or sphincter disturbances (9%). A complete resection was achieved in 11 operations and a subtotal tumour removal in 12 instances. After subtotal removal, 5 tumours were treated postoperatively using local high dose radiotherapy (60-70 Gy). Overall, every chordoma recurred with the passage of time unless en-bloc resection of the tumour had been performed. The recurrence-free interval tended to be longer after radiotherapy. Analysis of postoperative results revealed a significant positive effect of radiotherapy for motor function, pain, Karnofsky score, and survival. In conclusion, en-bloc resection should be performed whenever localization and extension of the tumour allow one to do so. Surgery should be followed by local high dose radiotherapy.
Klekamp
J
J
Neurosurgical Clinic, Medical School of Hannover, Nordstadt Hospital, Federal Republic of Germany.
Samii
M
M
D002817:Chordoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009460:Neurologic Examination; D018714:Radiotherapy, Adjuvant; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome