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学科主题: 临床医学
题名:
Chordomas of the upper cervical spine: clinical characteristics and surgical management of a series of 21 patients
作者: Zhou Hua; Jiang Liang; Wei Feng; Yu Miao; Wu Fengliang; Liu Xiaoguang; Liu Zhongjun; Dang Gengting
关键词: chordoma ; atlases ; general surgery ; therapeutics ; atlantoaxial
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2014-08-05
DOI: 10.3760/cma.j.issn.0366-6999.20132077
卷: 127, 期:15, 页:2759-2764
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: MOBILE SPINE ; PROGNOSTIC-FACTORS
英文摘要:

Background Chordomas of the upper cervical spine are rare and present unique surgical challenge. This study aimed to describe the clinical characteristics and surgical management of patients with chordomas of the upper cervical spine.

Methods Twenty-one patients with chordornas of the upper cervical spine who were treated in Peking University Third Hospital from January 1999 to October 2012 were retrospectively analyzed. Survival was calculated by the Kaplan-Meier method and was compared between groups using the log-rank test.

Results The postoperative diagnosis was classical chordoma in 20 cases and chondroid chordoma in one case. The mean operative time was 9.5 hours (range 6-17 hours), and the mean blood loss was 2 812 ml (range 700-4 800 ml). There were two postoperative deaths. Unilateral vertebral artery ligation was performed in six patients, cervical nerve roots were cut in six patients, and the external branch of the superior laryngeal nerve was repaired after being cut in one case. Two patients developed postoperative velopharyngeal incompetence, and loosening of the occipitocervical screws was observed in one patient. The recurrence rate was 66.7% (10/15) after a mean follow-up period of 46.8 months (range 14-150 months). The 5- and 10- year overall survival rates were (39.8 +/- 13.1)% and (31.9 +/- 12.7)%, respectively. There was a significant difference in survival rate between patients who underwent surgery and those who did not.

Conclusion In spite of the high rates of recurrence and complications after surgical treatment of chordomas of the upper cervical spine, intralesional resection combined with adjuvant radiotherapy remains the optimal treatment to prolong survival.

语种: 英语
所属项目编号: 20130001120091 ; 2010
项目资助者: Specialized Research Fund for the Doctoral Program of Higher Education of China ; State Key Clinical Specialty of Ministry of Health
WOS记录号: WOS:000340691000007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57853
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: Peking Univ, Hosp 3, Dept Orthopaed, Beijing Key Lab Spinal Dis, Beijing 100191, Peoples R China

Recommended Citation:
Zhou Hua,Jiang Liang,Wei Feng,et al. Chordomas of the upper cervical spine: clinical characteristics and surgical management of a series of 21 patients[J]. CHINESE MEDICAL JOURNAL,2014,127(15):2759-2764.
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