Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System

Matthew L. Carlson, Brendan P. O'Connell, Joseph T. Breen, Cameron C. Wick, Colin L. Driscoll, David S. Haynes, Reid C. Thompson, Brandon Isaacson, Paul W. Gidley, J. Walter Kutz, Jamie Van Gompel, George B. Wanna, Shaan M. Raza, Franco Demonte, Samuel L. Barnett, Michael J. Link

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Objective: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. Study Design: Retrospective case review, 1995 to 2015. Setting: Multicenter study. Patients: Consecutive patients with histopathologically proven petroclival chondrosarcoma. Intervention(s): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. Main Outcome Measures: Disease- and treatment-associated morbidity, recurrence, mortality. Results: Fifty-five patients (mean age 42 years; 56% women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55%) and diplopia (49%) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73%) patients and gross total resection in 12 (27%). Adjuvant postoperative radiation was administered in 30 (64%) cases. Preoperative cranial neuropathy improved in 13 (29%), worsened in 11 (24%), and remained stable in 21 (47%) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97%, 89%, 70%, and 56%, respectively. Higher tumor stage, larger categorical size (<4 versus ≥4 cm), lack of adjuvant radiation, and longer duration of follow-up were associated with greater risk of recurrence. The overall mortality rate was 2% for patients presenting with primary disease. Analyzing the cohort of 17 cases with 20 recurrences, 3 received salvage surgery alone, 5 radiation therapy alone, 11 multimodality treatment, and one patient has been observed. Tumor control was ultimately achieved in 15 of 17 patients with recurrent disease. One patient (6%) with grade 3 petroclival chondrosarcoma died as a result of rapidly progressive disease within 6 months of salvage treatment. The overall mortality rate was 6% for patients with recurrent disease. Conclusion: Gross total or subtotal resection with adjuvant radiation provides durable tumor control with minimal morbidity in most patients. Surgery may improve preoperative cranial nerve dysfunction, particularly in the case of cranial nerve 6 paralysis.

Original languageEnglish (US)
Pages (from-to)940-950
Number of pages11
JournalOtology and Neurotology
Volume37
Issue number7
DOIs
StatePublished - Aug 1 2016

Fingerprint

Chondrosarcoma
Recurrence
Radiotherapy
Microsurgery
Cranial Nerves
Radiation
Mortality
Neoplasms
Abducens Nerve Diseases
Morbidity
Cranial Nerve Diseases
Salvage Therapy
Diplopia
Paralysis
Multicenter Studies
Headache
Therapeutics
Survival Rate
Retrospective Studies

Keywords

  • Chondrosarcoma
  • Cranial base
  • Microsurgery
  • Neurotology
  • Skull base
  • Stereotactic radiosurgery
  • Temporal bone

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Carlson, M. L., O'Connell, B. P., Breen, J. T., Wick, C. C., Driscoll, C. L., Haynes, D. S., ... Link, M. J. (2016). Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System. Otology and Neurotology, 37(7), 940-950. https://doi.org/10.1097/MAO.0000000000001037

Petroclival Chondrosarcoma : A Multicenter Review of 55 Cases and New Staging System. / Carlson, Matthew L.; O'Connell, Brendan P.; Breen, Joseph T.; Wick, Cameron C.; Driscoll, Colin L.; Haynes, David S.; Thompson, Reid C.; Isaacson, Brandon; Gidley, Paul W.; Kutz, J. Walter; Van Gompel, Jamie; Wanna, George B.; Raza, Shaan M.; Demonte, Franco; Barnett, Samuel L.; Link, Michael J.

In: Otology and Neurotology, Vol. 37, No. 7, 01.08.2016, p. 940-950.

Research output: Contribution to journalReview article

Carlson, ML, O'Connell, BP, Breen, JT, Wick, CC, Driscoll, CL, Haynes, DS, Thompson, RC, Isaacson, B, Gidley, PW, Kutz, JW, Van Gompel, J, Wanna, GB, Raza, SM, Demonte, F, Barnett, SL & Link, MJ 2016, 'Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System', Otology and Neurotology, vol. 37, no. 7, pp. 940-950. https://doi.org/10.1097/MAO.0000000000001037
Carlson ML, O'Connell BP, Breen JT, Wick CC, Driscoll CL, Haynes DS et al. Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System. Otology and Neurotology. 2016 Aug 1;37(7):940-950. https://doi.org/10.1097/MAO.0000000000001037
Carlson, Matthew L. ; O'Connell, Brendan P. ; Breen, Joseph T. ; Wick, Cameron C. ; Driscoll, Colin L. ; Haynes, David S. ; Thompson, Reid C. ; Isaacson, Brandon ; Gidley, Paul W. ; Kutz, J. Walter ; Van Gompel, Jamie ; Wanna, George B. ; Raza, Shaan M. ; Demonte, Franco ; Barnett, Samuel L. ; Link, Michael J. / Petroclival Chondrosarcoma : A Multicenter Review of 55 Cases and New Staging System. In: Otology and Neurotology. 2016 ; Vol. 37, No. 7. pp. 940-950.
@article{3aef13c576a34dc3ac6b5c2e01f3812c,
title = "Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System",
abstract = "Objective: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. Study Design: Retrospective case review, 1995 to 2015. Setting: Multicenter study. Patients: Consecutive patients with histopathologically proven petroclival chondrosarcoma. Intervention(s): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. Main Outcome Measures: Disease- and treatment-associated morbidity, recurrence, mortality. Results: Fifty-five patients (mean age 42 years; 56{\%} women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55{\%}) and diplopia (49{\%}) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73{\%}) patients and gross total resection in 12 (27{\%}). Adjuvant postoperative radiation was administered in 30 (64{\%}) cases. Preoperative cranial neuropathy improved in 13 (29{\%}), worsened in 11 (24{\%}), and remained stable in 21 (47{\%}) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97{\%}, 89{\%}, 70{\%}, and 56{\%}, respectively. Higher tumor stage, larger categorical size (<4 versus ≥4 cm), lack of adjuvant radiation, and longer duration of follow-up were associated with greater risk of recurrence. The overall mortality rate was 2{\%} for patients presenting with primary disease. Analyzing the cohort of 17 cases with 20 recurrences, 3 received salvage surgery alone, 5 radiation therapy alone, 11 multimodality treatment, and one patient has been observed. Tumor control was ultimately achieved in 15 of 17 patients with recurrent disease. One patient (6{\%}) with grade 3 petroclival chondrosarcoma died as a result of rapidly progressive disease within 6 months of salvage treatment. The overall mortality rate was 6{\%} for patients with recurrent disease. Conclusion: Gross total or subtotal resection with adjuvant radiation provides durable tumor control with minimal morbidity in most patients. Surgery may improve preoperative cranial nerve dysfunction, particularly in the case of cranial nerve 6 paralysis.",
keywords = "Chondrosarcoma, Cranial base, Microsurgery, Neurotology, Skull base, Stereotactic radiosurgery, Temporal bone",
author = "Carlson, {Matthew L.} and O'Connell, {Brendan P.} and Breen, {Joseph T.} and Wick, {Cameron C.} and Driscoll, {Colin L.} and Haynes, {David S.} and Thompson, {Reid C.} and Brandon Isaacson and Gidley, {Paul W.} and Kutz, {J. Walter} and {Van Gompel}, Jamie and Wanna, {George B.} and Raza, {Shaan M.} and Franco Demonte and Barnett, {Samuel L.} and Link, {Michael J.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1097/MAO.0000000000001037",
language = "English (US)",
volume = "37",
pages = "940--950",
journal = "Otology and Neurotology",
issn = "1531-7129",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Petroclival Chondrosarcoma

T2 - A Multicenter Review of 55 Cases and New Staging System

AU - Carlson, Matthew L.

AU - O'Connell, Brendan P.

AU - Breen, Joseph T.

AU - Wick, Cameron C.

AU - Driscoll, Colin L.

AU - Haynes, David S.

AU - Thompson, Reid C.

AU - Isaacson, Brandon

AU - Gidley, Paul W.

AU - Kutz, J. Walter

AU - Van Gompel, Jamie

AU - Wanna, George B.

AU - Raza, Shaan M.

AU - Demonte, Franco

AU - Barnett, Samuel L.

AU - Link, Michael J.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Objective: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. Study Design: Retrospective case review, 1995 to 2015. Setting: Multicenter study. Patients: Consecutive patients with histopathologically proven petroclival chondrosarcoma. Intervention(s): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. Main Outcome Measures: Disease- and treatment-associated morbidity, recurrence, mortality. Results: Fifty-five patients (mean age 42 years; 56% women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55%) and diplopia (49%) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73%) patients and gross total resection in 12 (27%). Adjuvant postoperative radiation was administered in 30 (64%) cases. Preoperative cranial neuropathy improved in 13 (29%), worsened in 11 (24%), and remained stable in 21 (47%) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97%, 89%, 70%, and 56%, respectively. Higher tumor stage, larger categorical size (<4 versus ≥4 cm), lack of adjuvant radiation, and longer duration of follow-up were associated with greater risk of recurrence. The overall mortality rate was 2% for patients presenting with primary disease. Analyzing the cohort of 17 cases with 20 recurrences, 3 received salvage surgery alone, 5 radiation therapy alone, 11 multimodality treatment, and one patient has been observed. Tumor control was ultimately achieved in 15 of 17 patients with recurrent disease. One patient (6%) with grade 3 petroclival chondrosarcoma died as a result of rapidly progressive disease within 6 months of salvage treatment. The overall mortality rate was 6% for patients with recurrent disease. Conclusion: Gross total or subtotal resection with adjuvant radiation provides durable tumor control with minimal morbidity in most patients. Surgery may improve preoperative cranial nerve dysfunction, particularly in the case of cranial nerve 6 paralysis.

AB - Objective: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. Study Design: Retrospective case review, 1995 to 2015. Setting: Multicenter study. Patients: Consecutive patients with histopathologically proven petroclival chondrosarcoma. Intervention(s): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. Main Outcome Measures: Disease- and treatment-associated morbidity, recurrence, mortality. Results: Fifty-five patients (mean age 42 years; 56% women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55%) and diplopia (49%) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73%) patients and gross total resection in 12 (27%). Adjuvant postoperative radiation was administered in 30 (64%) cases. Preoperative cranial neuropathy improved in 13 (29%), worsened in 11 (24%), and remained stable in 21 (47%) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97%, 89%, 70%, and 56%, respectively. Higher tumor stage, larger categorical size (<4 versus ≥4 cm), lack of adjuvant radiation, and longer duration of follow-up were associated with greater risk of recurrence. The overall mortality rate was 2% for patients presenting with primary disease. Analyzing the cohort of 17 cases with 20 recurrences, 3 received salvage surgery alone, 5 radiation therapy alone, 11 multimodality treatment, and one patient has been observed. Tumor control was ultimately achieved in 15 of 17 patients with recurrent disease. One patient (6%) with grade 3 petroclival chondrosarcoma died as a result of rapidly progressive disease within 6 months of salvage treatment. The overall mortality rate was 6% for patients with recurrent disease. Conclusion: Gross total or subtotal resection with adjuvant radiation provides durable tumor control with minimal morbidity in most patients. Surgery may improve preoperative cranial nerve dysfunction, particularly in the case of cranial nerve 6 paralysis.

KW - Chondrosarcoma

KW - Cranial base

KW - Microsurgery

KW - Neurotology

KW - Skull base

KW - Stereotactic radiosurgery

KW - Temporal bone

UR - http://www.scopus.com/inward/record.url?scp=84973473506&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84973473506&partnerID=8YFLogxK

U2 - 10.1097/MAO.0000000000001037

DO - 10.1097/MAO.0000000000001037

M3 - Review article

C2 - 27273403

AN - SCOPUS:84973473506

VL - 37

SP - 940

EP - 950

JO - Otology and Neurotology

JF - Otology and Neurotology

SN - 1531-7129

IS - 7

ER -