{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:53:24Z","timestamp":1769925204561,"version":"3.49.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Chordomas are locally destructive neoplasms characterized by appreciable recurrence rates after initial multimodality treatment. We examined the outcome of salvage treatment in recurrent\/progressive skull base chordomas.<\/jats:p><jats:p>\n          Methods\u2003This is a retrospective review of recurrent\/progressive skull base chordomas at a tertiary urban academic medical center. The outcomes evaluated were overall survival, progression-free survival (PFS), and incidence of new toxicity.<\/jats:p><jats:p>\n          Results\u2003Eighteen consecutive patients who underwent \u22651 course of treatment (35.3% salvage surgery, 23.5% salvage radiation, and 41.2% both) were included. The median follow-up was 98.6 months (range 16\u2013215 months). After initial treatment, the median PFS was 17.7 months (95% confidence interval [CI]: 4.9\u201322.6 months). Following initial therapy, age\u2009\u2265\u200940 had improved PFS on univariate analysis (p\u2009=\u20090.03). All patients had local recurrence, with 15 undergoing salvage surgical resections and 16 undergoing salvage radiation treatments (mostly stereotactic radiosurgery [SRS]). The median PFS was 59.2 months (95% CI: 4.0\u201399.3 months) after salvage surgery, 58.4 months (95% CI: 25.9\u2013195 months) after salvage radiation, and 58.4 months (95% CI: 25.9.0\u201398.4 months) combined. Overall survival for the total cohort was 98.7%\u2009\u00b1\u20091.7% at 2 years and 92.8%\u2009\u00b1\u20095.5% at 5 years. Salvage treatments were well-tolerated with two patients (11%) reporting tinnitus and one patient each (6%) reporting headaches, visual field deficits, hearing loss, anosmia, dysphagia, or memory loss.<\/jats:p><jats:p>\n          Conclusion\u2003Refractory skull base chordomas present a challenging treatment dilemma. Repeat surgical resection or SRS seems to provide adequate salvage therapy that is well-tolerated when treated at a tertiary center offering multimodality care.<\/jats:p>","DOI":"10.1055\/s-0039-3402019","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T23:41:18Z","timestamp":1579045278000},"page":"161-174","source":"Crossref","is-referenced-by-count":2,"title":["Use of Salvage Surgery or Stereotactic Radiosurgery for Multiply Recurrent Skull Base Chordomas: A Single-Institution Experience and Review of the Literature"],"prefix":"10.1055","volume":"82","author":[{"given":"Stella K.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben A.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelly X.","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Garsa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason C.","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin H.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bozena B.","family":"Wrobel","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology Head and Neck Surgery, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Giannotta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"ref1","volume-title":"Chordomas and Chondrosarcomas of the Skull Base and Spine. 2nd ed","author":"G R Harsh","year":"2018"},{"key":"ref2","doi-asserted-by":"crossref","DOI":"10.1007\/978-94-007-4213-0","volume-title":"Tumors of the Central Nervous System, Volume 8 Astrocytoma, Medulloblastoma, Retinoblastoma, 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