title: Differences in Dural Penetration of Clival Chordomas Are Associated with Different Prognosis and Expression of Platelet-Derived Growth Factor Receptor-β.
abstract: OBJECTIVE
  We sought to compare the prognosis of clival chordomas with different dural penetration and establish the relationship between dural penetration and platelet-derived growth factor receptor (PDGFR)-β signaling pathway.
  
  
  METHODS
  Tumors in Type I (33 cases) showed limited dural penetration, while those in Type II (34 cases) had more serious dural penetration. Cox multivariate regression analysis was used to analyze risk factors affecting survival. Kaplan-Meier analysis measured overall survival (OS) and progression-free survival (PFS). To determine the relationship between dural penetration and PDGFR-β signaling, expression of PDGFR-β, Akt, mammalian target of rapamycin (mTOR), and phosphatase and tensin homolog (PTEN) expression was compared using immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and Western blotting.
  
  
  RESULTS
  Total resection was achieved in 9 cases in Type I and 11 in Type II. There were significant correlations between OS and dural penetration (P = 0.032) and age (P = 0.034). PFS correlated significantly with dural penetration (P = 0.022), gender (P = 0.001), and degree of resection (P = 0.001). Mean OS in Type I was significantly longer than in Type II (P = 0.046). Patients aged <55 years had longer OS than those aged ≥55 years (P = 0.004). Total resection was correlated with longer PFS (P = 0.011). Among patients with tumors totally resected, mean PFS in Type I was significantly longer than in Type II (P = 0.007). Expression of PDGFR-β in Type II was higher than in Type I.
  
  
  CONCLUSIONS
  Clival chordomas have different degrees of dural penetration. Patients with chordomas with serious dural penetration have poorer prognosis. Higher expression of PDGFR-β is related to more serious dural penetration of clival chordomas.
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Yixuan
authors: Y
authors: Zhai
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Jiwei
authors: J
authors: Bai
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Shuai
authors: S
authors: Wang
authors: Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Jiang
authors: J
authors: Du
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Jichao
authors: J
authors: Wang
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
authors: Chuzhong
authors: C
authors: Li
authors: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Songbai
authors: S
authors: Gui
authors: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Institute for Brain Disorders Brain Tumor Center, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China. Electronic address: zyz2004520@yeah.net.
authors: Yazhuo
authors: Y
authors: Zhang
mesh_terms: D000328:Adult; D002817:Chordoma / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000601:surgery; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020797:Receptor, Platelet-Derived Growth Factor beta / Q000096:biosynthesis* / Q000235:genetics; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery
chemical_list: D020797:Receptor, Platelet-Derived Growth Factor beta
keywords: Clival chordomas; Dura mater; Penetration; Platelet-derived growth factor receptor-β; Prognosis