Metastatic disease from spinal chordoma: A 10-year experience

Christopher M. McPherson, Dima Suki, Ian E. McCutcheon, Ziya L. Gokaslan, Laurence D. Rhines, Ehud Mendel

Research output: Contribution to journalArticle

Abstract

Object. Metastastic lesions have been reported in 5 to 40% of patients with spinal and sacrococcygeal chordoma, but few contemporary series of chordoma metastastic disease exist in the literature. Additionally, the outcome in patients with chordoma-induced metastastic neoplasms remains unclear. The authors performed a retrospective review of the neurosurgery database at the University of Texas M. D. Anderson Cancer Center in Houston to determine the incidence of metastatic disease in a contemporary series of spinal and sacrococcygeal chordoma as well as to determine the outcomes. Methods. Thirty-seven patients underwent surgery for spinal and sacrococcygeal chordoma between June 1, 1993, and March 31, 2004. All records were reviewed, and appropriate statistical analyses were used to compare patient data for preoperative characteristics, treatments, and outcomes. The authors identified seven patients (19%) in whom metastatic disease developed; in three the disease had metastasized to the lungs only, in two to the lungs and liver, and in two to distant locations in the spine. There were no significant differences in age, sex, tumor location, or history of radiation treatments between patients with and those without metastases. In cases with local recurrent tumors, metastastic disease was more likely to develop than in those without recurrence (28 compared with 0%, respectively; p = 0.07). In two (12%) of 17 patients who underwent en bloc resection, metastatic disease developed, whereas it developed in five (25%) of 20 patients treated by curettage (p = 0.42). The median time from first surgery to the appearance of metastatic disease, as calculated using the Kaplan-Meier method, was 143.4 months (95% confidence interval [CI] 66.8-219.9). The median survival duration of patients with metastatic disease after the first surgery was 106 months (95% CI 55.7-155.7), and this did not differ significantly from that in patients in whom no metastases developed (p = 0.93). Conclusions. Spinal chordoma metastasized to other locations in 19% of the patients in this series. In patients with local disease recurrence, metastatic lesions are more likely to develop. Metastatic lesions were shown to be aggressive in some cases. Surgery and chemotherapy can play a role in controlling metastatic disease.

Original languageEnglish (US)
Pages (from-to)277-280
Number of pages4
JournalJournal of Neurosurgery: Spine
Volume5
Issue number4
DOIs
StatePublished - Oct 2006
Externally publishedYes

Fingerprint

Spinal Diseases
Chordoma
antineoplaston A10
Neoplasms
Confidence Intervals
Neoplasm Metastasis
Recurrence
Lung
Curettage
Neurosurgery

Keywords

  • Chordoma
  • En bloc resection
  • Metastasis
  • Spine tumor
  • Vertebrectomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

McPherson, C. M., Suki, D., McCutcheon, I. E., Gokaslan, Z. L., Rhines, L. D., & Mendel, E. (2006). Metastatic disease from spinal chordoma: A 10-year experience. Journal of Neurosurgery: Spine, 5(4), 277-280. https://doi.org/10.3171/spi.2006.5.4.277

Metastatic disease from spinal chordoma : A 10-year experience. / McPherson, Christopher M.; Suki, Dima; McCutcheon, Ian E.; Gokaslan, Ziya L.; Rhines, Laurence D.; Mendel, Ehud.

In: Journal of Neurosurgery: Spine, Vol. 5, No. 4, 10.2006, p. 277-280.

Research output: Contribution to journalArticle

McPherson, CM, Suki, D, McCutcheon, IE, Gokaslan, ZL, Rhines, LD & Mendel, E 2006, 'Metastatic disease from spinal chordoma: A 10-year experience', Journal of Neurosurgery: Spine, vol. 5, no. 4, pp. 277-280. https://doi.org/10.3171/spi.2006.5.4.277
McPherson CM, Suki D, McCutcheon IE, Gokaslan ZL, Rhines LD, Mendel E. Metastatic disease from spinal chordoma: A 10-year experience. Journal of Neurosurgery: Spine. 2006 Oct;5(4):277-280. https://doi.org/10.3171/spi.2006.5.4.277
McPherson, Christopher M. ; Suki, Dima ; McCutcheon, Ian E. ; Gokaslan, Ziya L. ; Rhines, Laurence D. ; Mendel, Ehud. / Metastatic disease from spinal chordoma : A 10-year experience. In: Journal of Neurosurgery: Spine. 2006 ; Vol. 5, No. 4. pp. 277-280.
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abstract = "Object. Metastastic lesions have been reported in 5 to 40{\%} of patients with spinal and sacrococcygeal chordoma, but few contemporary series of chordoma metastastic disease exist in the literature. Additionally, the outcome in patients with chordoma-induced metastastic neoplasms remains unclear. The authors performed a retrospective review of the neurosurgery database at the University of Texas M. D. Anderson Cancer Center in Houston to determine the incidence of metastatic disease in a contemporary series of spinal and sacrococcygeal chordoma as well as to determine the outcomes. Methods. Thirty-seven patients underwent surgery for spinal and sacrococcygeal chordoma between June 1, 1993, and March 31, 2004. All records were reviewed, and appropriate statistical analyses were used to compare patient data for preoperative characteristics, treatments, and outcomes. The authors identified seven patients (19{\%}) in whom metastatic disease developed; in three the disease had metastasized to the lungs only, in two to the lungs and liver, and in two to distant locations in the spine. There were no significant differences in age, sex, tumor location, or history of radiation treatments between patients with and those without metastases. In cases with local recurrent tumors, metastastic disease was more likely to develop than in those without recurrence (28 compared with 0{\%}, respectively; p = 0.07). In two (12{\%}) of 17 patients who underwent en bloc resection, metastatic disease developed, whereas it developed in five (25{\%}) of 20 patients treated by curettage (p = 0.42). The median time from first surgery to the appearance of metastatic disease, as calculated using the Kaplan-Meier method, was 143.4 months (95{\%} confidence interval [CI] 66.8-219.9). The median survival duration of patients with metastatic disease after the first surgery was 106 months (95{\%} CI 55.7-155.7), and this did not differ significantly from that in patients in whom no metastases developed (p = 0.93). Conclusions. Spinal chordoma metastasized to other locations in 19{\%} of the patients in this series. In patients with local disease recurrence, metastatic lesions are more likely to develop. Metastatic lesions were shown to be aggressive in some cases. Surgery and chemotherapy can play a role in controlling metastatic disease.",
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AU - Rhines, Laurence D.

AU - Mendel, Ehud

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N2 - Object. Metastastic lesions have been reported in 5 to 40% of patients with spinal and sacrococcygeal chordoma, but few contemporary series of chordoma metastastic disease exist in the literature. Additionally, the outcome in patients with chordoma-induced metastastic neoplasms remains unclear. The authors performed a retrospective review of the neurosurgery database at the University of Texas M. D. Anderson Cancer Center in Houston to determine the incidence of metastatic disease in a contemporary series of spinal and sacrococcygeal chordoma as well as to determine the outcomes. Methods. Thirty-seven patients underwent surgery for spinal and sacrococcygeal chordoma between June 1, 1993, and March 31, 2004. All records were reviewed, and appropriate statistical analyses were used to compare patient data for preoperative characteristics, treatments, and outcomes. The authors identified seven patients (19%) in whom metastatic disease developed; in three the disease had metastasized to the lungs only, in two to the lungs and liver, and in two to distant locations in the spine. There were no significant differences in age, sex, tumor location, or history of radiation treatments between patients with and those without metastases. In cases with local recurrent tumors, metastastic disease was more likely to develop than in those without recurrence (28 compared with 0%, respectively; p = 0.07). In two (12%) of 17 patients who underwent en bloc resection, metastatic disease developed, whereas it developed in five (25%) of 20 patients treated by curettage (p = 0.42). The median time from first surgery to the appearance of metastatic disease, as calculated using the Kaplan-Meier method, was 143.4 months (95% confidence interval [CI] 66.8-219.9). The median survival duration of patients with metastatic disease after the first surgery was 106 months (95% CI 55.7-155.7), and this did not differ significantly from that in patients in whom no metastases developed (p = 0.93). Conclusions. Spinal chordoma metastasized to other locations in 19% of the patients in this series. In patients with local disease recurrence, metastatic lesions are more likely to develop. Metastatic lesions were shown to be aggressive in some cases. Surgery and chemotherapy can play a role in controlling metastatic disease.

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KW - Spine tumor

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