title: Endonasal Endoscopic Resection and Radiotherapy in Skull Base Chordomas.
abstract: OBJECTIVE
  This study evaluates the impact combined endonasal endoscopic resection and radiotherapy for skull base chordomas.
  
  
  METHODS
  Thirty-two patients with skull base chordomas between July 2006 and June 2015 were divided into 2 groups: the surgery alone group and the surgery with radiation therapy group.
  
  
  RESULTS
  Gross total resection was achieved in 9 (28.1%) patients with skull base chordoma, subtotal resection was achieved in 16 (50.0%) patients, and partial resection was achieved in 7 (21.9%) patients. The progression-free survival (PFS) rate at 3 and 5 years was 44.0% and 16.5%, respectively. The overall survival (OS) rate at 3 and 5 years was 79.4% and 69.5%, respectively. Kadish staging predicted PFS and OS with statistical significance when the extent of resection was categorized into gross total resection, subtotal resection, and partial resection (P = 0.035 and P = 0.003, respectively). There was a significant OS advantage for the surgery plus radiation group compared with the surgery alone group (P = 0.035).
  
  
  CONCLUSIONS
  Gross total resection can achieve very good results for the treatment of skull base chordomas. Postoperative adjuvant radiation therapy is recommended for all skull base chordomas, as it offered a higher OS rate.
authors: Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
authors: Huan-Kang
authors: HK
authors: Zhang
authors: Xi-Cai
authors: XC
authors: Sun
authors: Li
authors: L
authors: Hu
authors: Jing-Jing
authors: JJ
authors: Wang
authors: De-Hui
authors: DH
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002817:Chordoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome