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J Wound Care 2022 May;31(Sup5):S30-S32

Advent Health North Pinellas Wound Healing Institute of Trinity, New Port Richey, FL, US.

Chordoma is a rare form of cancer that forms from the notochord remnants, and affects the skull and the spine. The standard treatment for a sacrococcygeal chordoma is surgery and radiation. Chordoma has a high rate of recurrence and surgery with radiation treatment can leave patients with surgical site complications, such as wounds, fistulas or sinus tracts. Read More

J Am Acad Orthop Surg 2022 May 3. Epub 2022 May 3.

From the Department of Orthopedic Surgery, University of California-San Francisco (UCSF) (Stroud, Geiger, Wustrack, and Theologis), the Department of Epidemiology and Biostatistics, UCSF (Lichtensztajn, and Cheng), and the Department of Pediatric Hematology-Oncology, UCSF, San Francisco, CA (Goldsby).

Introduction: Malignancies of the mobile spine carry high morbidity and mortality. This study sought to examine factors associated with receipt of "standard" treatment and survival for patients with primary mobile spine tumors in the California Cancer Registry (CCR).

Methods: The CCR (1988 to 2016) data were obtained for patients with primary tumors of the mobile spine and at least 1-year follow-up. Read More

J Neurooncol 2022 May 4. Epub 2022 May 4.

Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.

Purpose: Chordomas are malignant tumors that develop along the neuraxis between skull-base and sacrum. Chondrosarcomas show similarities with chordomas, yet show less malignant behavior. LIM and SH3 protein 1 (LASP1) is a cytoskeletal protein known to promote the malignant behavior of tumors. Read More

Spine J 2022 Apr 22. Epub 2022 Apr 22.

Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background Context: Local control remains a vexing problem in the management of chordoma despite advances in operative techniques and radiotherapy (RT) protocols. Existing studies show satisfactory local control rates with different treatment modalities. However, those studies with minimum follow-up more than 4 years demonstrate increasing rates of local failure. Read More

J Neurooncol 2022 Apr 22. Epub 2022 Apr 22.

Department of Spine Surgery, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil.

Purpose: To report preliminary outcomes of high dose image-guided intensity modulated radiotherapy (IG-IMRT) in the treatment of chordomas of the sacrum, mobile spine and skull base.

Methods: Retrospective analysis of chordoma patients treated with surgery and/or radiotherapy (RT) in a single tertiary cancer center. Initial treatment was categorized as (A) Adjuvant or definitive high-dose RT (78 Gy/39fx or 24 Gy/1fx) vs (B) surgery-only or low dose RT. Read More

Radiother Oncol 2022 Apr 13;171:139-145. Epub 2022 Apr 13.

Department of Radiation Oncology, Massachusetts General Hospital, Boston, United States.

Background/purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy.In certain locations, resection may result in significant neurological dysfunction, so definitive radiation has been used as an alternative to surgery. The purpose of this study is to report the results of high-dose, proton-based definitive radiotherapy for unresected spinal and sacral chordomas. Read More

Ann Transl Med 2022 Jan;10(2):61

Department of Orthopedics, the First Affiliated Hospital of Soochow University, Soochow University, Suzhou, China.

Background: Chordoma is a rare malignant bone tumor with high recurrence and metastasis rates. Little is known about the mutational process of this incurable disease. The aim of our research was to explore the potential driver genes and signal pathways in the pathogenesis of chordoma and provide a new idea for the study of molecular biological therapy of chordoma. Read More

Surg Neurol Int 2022 18;13:63. Epub 2022 Feb 18.

Department of Neurosurgery, CHU Ibn Sina, Rabat, Morocco.

Background: Chordomas are rare benign, but locally aggressive tumors that are regularly encountered in the clivus and sacrum. Although they are rarely found in the thoracic spine, they can contribute not only to local bone destruction and spinal instability, lead to cord compression, and major neurological deficits.

Case Description: A 56 year-old-male originally underwent a T12 laminectomy with debulking for a thoracic chordoma. Read More

Sci Adv 2022 02 16;8(7):eabl3674. Epub 2022 Feb 16.

Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Chordomas are rare tumors of notochordal origin, most commonly arising in the sacrum or skull base. Chordomas are considered insensitive to conventional chemotherapy, and their rarity complicates running timely and adequately powered trials to identify effective treatments. Therefore, there is a need for discovery of novel therapeutic approaches. Read More

N Am Spine Soc J 2021 Dec 29;8:100090. Epub 2021 Oct 29.

University Spine Center Zürich, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland.

Background: Chordomas are rare, locally aggressive, malignant tumors. Surgical resection with sufficient margins defines the outcome. However, the necessity for wide margins often leads to sacrifice of important neurological structures. Read More

Indian J Radiol Imaging 2021 Oct 11;31(4):809-829. Epub 2022 Jan 11.

Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India.

 Spinal dysraphisms refer to the congenital abnormalities of the spine and spinal cord due to aberrations in the processes of gastrulation, primary neurulation, and secondary neurulation. Embryology of many complex spinal dysraphisms are yet poorly understood and there is no agreeable anatomical-clinicoradiological classification with inclusion of recently documented and complex spinal dysraphisms.  The main objective of this study was to review the imaging features of spinal dysraphisms with a better understanding of embryological abnormalities and propose a new classification inclusive of all complex and unusual dysraphisms based on anatomical and clinicoradiological correlation. Read More

Neurospine 2022 Mar 30;19(1):155-162. Epub 2022 Jan 30.

A.U.O. "Policlinico Umberto I", Neurosurgery Division, Sapienza University, Human Neurosciences Department, Roma, Italy.

Objective: Chordomas are slow-growing tumors, with a high tendency to local relapse. En bloc resection is related to the most favorable outcome in terms of survival but is frequently associated with permanent neurological deficits involving sphincters and sexual functions. In the present article, we describe an innovative technique of en bloc resection followed by reconstruction of the sacral nerves with nerve grafts. Read More

Indian J Surg Oncol 2021 Dec 19;12(4):750-758. Epub 2021 Nov 19.

Department of Surgical Oncology, Army Hospital Research and Referral, Delhi Cantt, 110010 India.

Conventional chordomas occur most commonly in the sacral region. Currently, wide local excision remains the only hope for a cure in this disease. However, given the substantial morbidity caused by sacrectomy, a delicate balance needs to be established. Read More

Anticancer Res 2022 Feb;42(2):929-937

Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland;

Background/aim: Sacral chordoma is a rare primary bone neoplasm associated with high morbidity. The aim of this study is to identify demographic and clinicopathological characteristics of this tumor and evaluate their impact on survival outcomes.

Patients And Methods: The Surveillance, Epidemiology and End Results (SEER) database collecting data between 2000 and 2018 was searched for all cases of sacral chordoma. Read More

Front Surg 2021 5;8:698179. Epub 2022 Jan 5.

Department of Spine Surgery, Semmelweis University, Budapest, Hungary.

En-bloc resection of a primary malignant sacral tumor with wide oncological margins impacts the biomechanics of the spinopelvic complex, deteriorating postoperative function. The closed-loop technique (CLT) for spinopelvic fixation (SPF) uses a single U-shaped rod to restore the spinopelvic biomechanical integrity. The CLT method was designed to provide a non-rigid fixation, however this hypothesis has not been previously tested. Read More

J Craniovertebr Junction Spine 2021 Oct-Dec;12(4):412-419. Epub 2021 Dec 11.

Department of Neurosurgery, Ege University, Izmir, Turkey.

Study Design: Retrospective clinical series.

Purpose: To search for spinal chordoma's survival rates, recurrences, and complications and compare sacral and mobile spine chordomas.

Overview Of Literature: The primary spinal chordoma treatment is mainly considered radical surgery, although recurrence rates are pretty high. Read More

Orthop Traumatol Surg Res 2022 Jan 7:103197. Epub 2022 Jan 7.

Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service de Chirurgie Orthopédique et Traumatologique, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address:

Introduction: For prolonged survival, primary malignant sacral tumors (PMST) are treated by En Bloc sacrectomy. Few studies analyzed specifically the surgical site infections (SSI) for this condition and whether they impact on the patients' survivals.

Objectives: The objectives were to (1) describe their characteristics; (2) compare the survivals of infected and non-infected patients; (3) identify patients- and surgery-related risk factors. Read More

JAMA Netw Open 2022 01 4;5(1):e2141927. Epub 2022 Jan 4.

Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.

Importance: Maximal resection is the preferred management for sacral chordomas but can be associated with unacceptable morbidity. Outcomes with radiotherapy are poor. Carbon ion radiotherapy (CIRT) is being explored as an alternative when surgery is not preferred. Read More

J Surg Oncol 2022 Mar 21;125(4):790-795. Epub 2021 Dec 21.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Introduction: Sacral tumor resection is known for a high rate of complications. Sarcopenia has been found to be associated with wound complications; however, there is a paucity of data examining the impact of sarcopenia on the outcome of sacral tumor resection.

Methods: Forty-eight patients (31 primary sarcomas, 17 locally recurrent carcinomas) undergoing sacrectomy were reviewed. Read More

Orthop Traumatol Surg Res 2022 02 7;108(1S):103169. Epub 2021 Dec 7.

Service d'Orthopédie et Traumatologie de l'Hôpital de Bicêtre, Université Paris-Saclay, 78, rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.

Chordoma is a very rare, poorly known malignancy, with slow progression, mainly located in the sacrum and spine. All age groups may be affected, with a diagnostic peak in the 5th decade of life. Clinical diagnosis is often late. Read More

Cancers (Basel) 2021 Dec 4;13(23). Epub 2021 Dec 4.

Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

Background: Chordoma is a cancer of spinal cord, skull base, and sacral area. Currently, the standard of care to treat chordoma is resection followed by radiation therapy. Since, chordoma is present in the spinal cord and these are very sensitive structures and often complete removal by surgery is not possible. Read More

Front Oncol 2021 15;11:659662. Epub 2021 Nov 15.

Orthopedics Department, West China Hospital, Sichuan University, Chengdu, China.

Objective: chordomas are rare bone tumors with few therapeutic options. Skull base and sacrum are the two most common origin sites. Immunotherapies are emerging as the most promising approaches to fight various cancers. Read More

Radiother Oncol 2022 01 26;166:58-64. Epub 2021 Nov 26.

HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, The Netherlands. Electronic address:

Background: Due to its specific physical characteristics, proton irradiation is especially suited for irradiation of chordomas and chondrosarcoma in the axial skeleton. Robust plan optimization renders the proton beam therapy more predictable upon individual setup errors. Reported experience with the planning and delivery of robustly optimized plans in chordoma and chondrosarcoma of the mobile spine and sacrum, is limited. Read More

J Fam Pract 2021 09;70(7):359-361

Liberty University College of Osteopathic Medicine, Lynchburg, VA (Drs. Forker and Masih);Einstein Medical Center Montgomery, Internal Medicine Residency, East Norriton, PA (Dr. Forker); University of Toledo Medical Center, Urology Residency Program, OH (Dr. Masih); MartinsvilleSurgical Associates, SOVAH Health, VA (Dr. O'Neil).

► Tail bone pain ► Unintended weight loss ► History of diabetes and hypertension. Read More

JBJS Case Connect 2021 11 22;11(4). Epub 2021 Nov 22.

The Department of Orthopaedic Surgery, Gifu University School of Medicine, Gifu, Japan.

Case: A 53-year-old man was referred to our institution for the treatment of sacral chordoma and underwent a wide resection. Multiple lung metastases were observed in both the lungs, a year after the surgery, and the diagnosis was confirmed by biopsy. The patient refused treatment, and the lesions continued to increase in size gradually. Read More

Cureus 2021 Oct 11;13(10):e18690. Epub 2021 Oct 11.

Breast and Soft Tissue Surgery, Instituto Nacional de Cancerología, Bogotá D.C., COL.

Sacral chordomas are malignant, locally aggressive, and rare tumors. Its presentation can be diverse on the entire spine, being more frequent in the sacrococcygeal region. The main treatment is complete surgical resection, which can be performed using different approaches depending on the case. Read More

Clin Nucl Med 2022 Apr;47(4):329-330

Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Abstract: A 47-year-old woman presented with low back pain for 2 months. Her CT scan showed a soft tissue mass in S3 to S4 vertebral bodies. The patient was subsequently enrolled in our 68Ga-FAPI clinical trial on tumors (ChiCTR2100044131). Read More

Asian J Endosc Surg 2022 Apr 20;15(2):363-367. Epub 2021 Oct 20.

Department of Surgery, Shinshu University School of Medicine, Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Matsumoto, Japan.

Radical surgical procedures for malignant diseases of the pelvis result in a large pelvic defect that requires soft tissue reconstruction. The mesentery can be used for pelvic floor reconstruction when debridement with intestinal resection is required. A 75-year-old woman was diagnosed with sacral necrosis, infection and sepsis after carbon ion radiotherapy for sacral chordoma. Read More

Phys Med 2021 Oct 7;90:123-133. Epub 2021 Oct 7.

Bioengineering Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy; Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy.

Purpose: Carbon ion radiotherapy (CIRT) is sensitive to anatomical density variations. We examined the dosimetric effect of variable intestinal filling condition during CIRT to ten sacral chordoma patients.

Methods: For each patient, eight virtual computed tomography scans (vCTs) were generated by varying the density distribution within the rectum and the sigmoid in the planning computed tomography (pCT) with a density override approach mimicking a heterogeneous combination of gas and feces. Read More

Front Oncol 2021 9;11:709659. Epub 2021 Sep 9.

Department of Radiology, Peking University People's Hospital, Beijing, China.

Purpose: To assess the performance of random forest (RF)-based radiomics approaches based on 3D computed tomography (CT) and clinical features to predict the types of pelvic and sacral tumors.

Materials And Methods: A total of 795 patients with pathologically confirmed pelvic and sacral tumors were analyzed, including metastatic tumors (n = 181), chordomas (n = 85), giant cell tumors (n =120), chondrosarcoma (n = 127), osteosarcoma (n = 106), neurogenic tumors (n = 95), and Ewing's sarcoma (n = 81). After semi-automatic segmentation, 1316 hand-crafted radiomics features of each patient were extracted. Read More