1
|
Brown NJ, Gendreau J, Kuo CC, Nguyen O, Yang C, Catapano JS, Lawton MT. Assessing survival outcomes and complication profiles following surgical excision and radiotherapy as interventions for skull base chordoma: a systematic review of operative margins and surgical approaches. J Neurooncol 2023; 165:41-51. [PMID: 37880419 DOI: 10.1007/s11060-023-04477-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Despite their precarious behavioral classification (benign and low grade on histopathology yet behaviorally malignant), great strides have been taken to improve prognostication and treatment paradigms for patients with skull base chordoma. With respect to surgical techniques, lateral transcranial (TC) approaches have traditionally been used, however endoscopic endonasal approaches (EEA) have been advocated for midline lesions. Nonetheless, due to the rarity of this pathology (0.2% of all intracranial neoplasms), investigations within the literature remain limited to small retrospective series. Furthermore, radiotherapeutic treatments investigated to date have proven largely ineffective. METHODS Accordingly, we performed a systematic review in order to profile surgical and survival outcomes for skull base chordoma. Fixed and random-effect meta-analyses were performed for categorical variables including GTR, STR, 5-year OS, 10-year OS, 5-year PFS, and 10-year PFS. Additionally, we pooled eligible studies for formal meta-analysis to compare outcomes by surgical approach (lateral versus midline). Statistical analyses were performed using R Studio 'metafor' package or Cochrane Review Manager. Furthermore, meta-analysis of pooled mortality rates and sub-analyses of operative margin and surgical complications were used to compare midline versus lateral approaches via the Mantel-Haenszel method. We considered all p-values < 0.05 to be statistically significant. RESULTS Following the systematic search and screen, 55 studies published between 1993 and 2022 reporting data for 2453 patients remained eligible for analysis. Sex distribution was comparable between males and females, with a slight predominance of male-identifying patients (0.5625 [95% CI: 0.5418; 0.3909]). Average age at diagnosis was 42.4 ± 12.5 years, while average age of treatment initiation was 43.0 ± 10.6 years. Overall, I2 value indicated notable heterogeneity across the 55 studies [I2 = 56.3% (95%CI: 44.0%; 65.9%)]. With respect to operative margins, the rate of GTR was 0.3323 [95% CI: 0.2824; 0.3909], I2 = 91.9% [95% CI: 90.2%; 93.4%], while the rate of STR was significantly higher at 0.5167 [95% CI: 0.4596; 0.5808], I2 = 93.1% [95% CI: 91.6%; 94.4%]. The most common complication was CSF leak (5.4%). In terms of survival outcomes, 5-year OS rate was 0.7113 [95% CI: 0.6685; 0.7568], I2 = 91.9% [95% CI: 90.0%; 93.5%]. 10-year OS rate was 0.4957 [95% CI: 0.4230; 0.5809], I2 = 92.3% [95% CI: 89.2%; 94.4%], which was comparable to the 5-year PFS rate of 0.5054 [95% CI: 0.4394; 0.5813], I2 = 84.2% [95% CI: 77.6%; 88.8%] and 10-yr PFS rate of 0.4949 [95% CI: 0.4075; 0.6010], I2 = 14.9% [95% CI: 0.0%; 87.0%]. There were 55 reported deaths for a perioperative mortality rate of 2.5%. The relative risk for mortality in the midline group versus the lateral approach group did not indicate any substantial difference in survival according to laterality of approach (-0.93 [95% CI: -1.03, -0.97], I2 = 95%, (p < 0.001). CONCLUSION Overall, these results indicate good 5-year survival outcomes for patients with skull base chordoma; however, 10-year prognosis for skull base chordoma remains poor due to its radiotherapeutic resistance and high recurrence rate. Furthermore, mortality rates among patients undergoing midline versus lateral skull base approaches appear to be equivocal.
Collapse
Affiliation(s)
- Nolan J Brown
- Department of Neurological Surgery, University of California-Irvine, Orange, CA, USA
| | - Julian Gendreau
- Johns Hopkins Whiting School of Engineering, Baltimore, MD, USA
| | - Cathleen C Kuo
- Department of Neurological Surgery, University of California-Irvine, Orange, CA, USA
| | - Oanh Nguyen
- Department of Neurological Surgery, University of California-Irvine, Orange, CA, USA
| | - Chenyi Yang
- Department of Neurological Surgery, University of California-Irvine, Orange, CA, USA
| | - Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, 2910 North Third Avenue, Phoenix, AZ, 85013, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, 2910 North Third Avenue, Phoenix, AZ, 85013, USA.
| |
Collapse
|
2
|
Pattankar S, Warade A, Misra BK, Deshpande RB. Long-term outcome of adjunctive Gamma Knife radiosurgery in skull-base chordomas and chondrosarcomas: An Indian experience. J Clin Neurosci 2022; 96:90-100. [PMID: 35030499 DOI: 10.1016/j.jocn.2021.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
Skull-base chordomas (CD) and chondrosarcomas (CS) are locally-invasive tumors, have similar clinical presentations, while differing in their nature of growth and outcomes. In this study, we compare the long-term outcomes of Gamma Knife Radiosurgery (GKRS) as an adjunctive treatment modality for residual skull-base CD and CS. A retrospective analysis of clinico-radiological, pathological, radiotherapeutic and outcome data was carried out in patients who underwent adjunctive GKRS for residual skull-base CD and CS at P D Hinduja Hospital, Mumbai, between 1997 and 2020. All 27 patients included had either histopathologically proven CD (20 patients) or CS (7 patients). Brachyury immunohistochemistry in CD specimens gave 70.6% positivity. Total sessions of GKRS in CD and CS groups were 22 and 7, respectively. Mean tumor volume and mean margin dose in CD group were 6.53 ± 4.18 cm3 and 15.95 ± 1.49 Gy respectively, while for CS group, they were 4.16 ± 2.79 cm3 and 18.29 ± 3.15 Gy. With mean follow-up periods of 5.25 ± 4.73 years and 6 ± 2.07 years respectively, the CD and CS groups showed 5-year progression free survival (PFS) of 56.8% and 57.1%, and a 5-year overall survival (OS) of 82.1% and 100%. Sub-group analysis in both CD and CS groups revealed a better 5-year PFS with the following factors - CS histopathology, patient age < 45 years, margin dose > 16 Gy, tumor volume < 7 cm3 (p-value < 0.05), gross total resection, and brachyury positivity. Adjunctive radiotherapy for skull-base CD and CS holds promise.
Collapse
Affiliation(s)
- Sanjeev Pattankar
- Department of Neurosurgery & Gamma Knife, P D Hinduja National Hospital, Mumbai 400016, India
| | - Anshu Warade
- Department of Neurosurgery & Gamma Knife, P D Hinduja National Hospital, Mumbai 400016, India
| | - Basant K Misra
- Department of Neurosurgery & Gamma Knife, P D Hinduja National Hospital, Mumbai 400016, India.
| | - Ramesh B Deshpande
- Department of Pathology, P D Hinduja National Hospital, Mumbai 400016, India
| |
Collapse
|
3
|
Dridi M, Boutonnat J, Dumollard JM, Peoc'h M, Karpathiou G. Patterns of brachyury expression in chordomas. Ann Diagn Pathol 2021; 53:151760. [PMID: 33989961 DOI: 10.1016/j.anndiagpath.2021.151760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Chordomas are rare malignant midline tumors, presumed to arise from notochordal remnants. This was further suggested by the discovery of the brachyury in chordomas pathogenesis. Its immunohistochemical expression has become the principal adjunct in the diagnosis of chordomas. However, studies about brachyury expression in chordomas are not fully comparable, mainly because they use different primary antibodies. Thus, the aim of this study is to investigate the expression of brachyury expression in a series of chordomas in conjunction to clinicopathological characteristics and to review the relevant literature providing all the details needed in the immunohistochemical study of brachyury. MATERIALS AND METHODS This is a retrospective study of 62 chordomas, diagnosed over a 22-year period. No dedifferentiated or poorly differentiated cases were included. A monoclonal primary antibody (clone A-4) was used and brachyury expression was evaluated by the H-score. Clinicopathological parameters studied were age, sex, tumor localization, decalcification status and tissue age. Fetal notochords were used for comparison. RESULTS Mean H-score of nuclear brachyury expression was 129.8. The tissue age significantly influenced brachyury expression, the older samples expressing less brachyury. Decalcification demonstrated a trend to weaken brachyury expression. Clinical characteristics were not correlated with the patterns of brachyury expression. Notochords were negative. Literature review reveals several polyclonal antibodies used and a positivity of 75%-100% in chordomas with even more variable results in notochords. CONCLUSION In chordomas, as in other tumor types, an uniformization of studies about brachyury expression is needed, by considering the clone used, and the decalcification and the age of the sample, given the growing importance of brachyury in diagnosis and therapeutic steps.
Collapse
Affiliation(s)
- Maroa Dridi
- Pathology Departments, University Hospital of Saint-Etienne, France
| | | | | | - Michel Peoc'h
- Pathology Departments, University Hospital of Saint-Etienne, France
| | | |
Collapse
|
4
|
Thanindratarn P, Dean DC, Nelson SD, Hornicek FJ, Duan Z. T-LAK cell-originated protein kinase (TOPK) is a Novel Prognostic and Therapeutic Target in Chordoma. Cell Prolif 2020; 53:e12901. [PMID: 32960500 PMCID: PMC7574876 DOI: 10.1111/cpr.12901] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/15/2020] [Accepted: 08/24/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives To assess the expression, prognostic value, and functionality of T‐lymphokine‐activated killer (T‐LAK) cell‐originated protein kinase (TOPK) in chordoma pathogenesis. Materials and Methods TOPK expression in chordoma was assessed via immunohistochemical staining of a tissue microarray (TMA) and correlated with patient clinicopathology. TOPK expression in chordoma cell lines and fresh patient tissues was then evaluated by Western blot. TOPK small interfering RNA (siRNA) and the specific inhibitor OTS514 were applied to determine the roles of TOPK in chordoma pathogenicity. The effect of TOPK expression on chordoma cell clonogenicity was also investigated using clonogenic assays. A 3D cell culture model was utilized to mimic in vivo environment to validate the effect of TOPK inhibition on chordoma cells. Results TOPK was highly expressed in 78.2% of the chordoma specimens in the TMA and all chordoma cell lines. High TOPK expression significantly correlated with metastasis, recurrence, disease status and shorter overall survival. Knockdown of TOPK with specific siRNA resulted in significantly decrease chordoma cell viability. Inhibition of TOPK with OTS514 significantly inhibited chordoma cell growth and proliferation, colony‐forming capacity and ex vivo spheroid growth. Conclusions High expression of TOPK is an important predictor of poor prognosis in chordoma. Inhibition of TOPK resulted in significantly decrease chordoma cell proliferation and increase apoptosis. Our results indicate TOPK as a novel prognostic biomarker and therapeutic target for chordoma.
Collapse
Affiliation(s)
- Pichaya Thanindratarn
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Orthopedic Surgery, Chulabhorn hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Dylan C Dean
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Francis J Hornicek
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Zhenfeng Duan
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| |
Collapse
|
5
|
Pagliuca F, Ronchi A, Cozzolino I, Montella M, Zito Marino F, Franco R. Mesenchymal neoplasms: Is it time for cytology? New perspectives for the pre-operative diagnosis of soft tissue tumors in the molecular era. Pathol Res Pract 2020; 216:152923. [PMID: 32303388 DOI: 10.1016/j.prp.2020.152923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/08/2020] [Accepted: 03/14/2020] [Indexed: 12/26/2022]
Abstract
Soft tissue tumors comprise a great variety of common and rare entities with overlapping features. Their diagnosis is based on the evaluation of several histological parameters which are difficult to assess on small incisional biopsies. Useful diagnostic markers in the field of soft tissue tumors include: 1) molecular biomarkers detecting pathogenetically relevant, distinctive alterations; 2) immunohistochemical surrogate biomarkers of pathogenetically relevant, distinctive molecular alterations; 3) highly specific immunohistochemical biomarkers indicating tumor differentiation. Their introduction in clinical practice has revolutionized the pre-operative diagnosis of soft tissue tumors. Cytology has long been considered inadequate as a first-line approach in this setting. However, since the implementation of new immunohistochemical and molecular tests with high diagnostic specificity, fine needle aspiration cytology (FNAC) is starting to gain acceptance for the pre-operative assessment of soft tissue tumors. FNAC represents a versatile, poorly expensive and well-tolerated diagnostic strategy with relevant advantages over histological biopsies. Moreover, evidences suggest that, in expert hands, FNAC can also aim at a definite diagnosis, especially if a cell block is prepared, allowing the application of multiple ancillary techniques.
Collapse
Affiliation(s)
- Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| |
Collapse
|
6
|
Ma J, Chen W, Wang K, Tian K, Li Q, Zhao T, Zhang L, Wang L, Wu Z, Zhang J. Identification of the Different Roles and Potential Mechanisms of T Isoforms in the Tumor Recurrence and Cell Cycle of Chordomas. Onco Targets Ther 2019; 12:11777-11791. [PMID: 32099384 PMCID: PMC6997418 DOI: 10.2147/ott.s232526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/19/2019] [Indexed: 12/16/2022] Open
Abstract
Purpose The roles of T (brachyury) isoforms in chordomas remain unclear. This study aimed to investigate the different roles and mechanisms of them in chordomas. Patients and methods The expression of T isoforms mRNAs in 57 chordomas was assessed, and a prognosis analysis was conducted. Cell apoptosis, proliferation and cell cycle assays were performed after specific T isoform mRNA knockdown. Whole-transcriptome sequencing, Gene Set Enrichment Analysis, Gene Ontology analysis, Kyoto Encyclopedia of Genes and Genomes analysis and competing endogenous RNA (ceRNA) analysis were conducted. Results As revealed in this study, the T-long isoform was a significant risk factor (hazard ratio [HR], 1.09; P=0.018) and the T-short isoform was a protective factor (HR, 0.24; P=0.012) associated with tumor recurrence. After T-long isoform knockdown, the cell cycle was arrested at G0/G1 phase and cell proliferation was significantly inhibited. A bioinformatic analysis revealed that the upregulation of H19, P21 and GADD45B; downregulation of SKP2 and CDK2; and accompanying changes in the P53 signaling pathway consistently contributed to G0/G1 arrest. After T-short isoform knockdown, the cell cycle was arrested at G2/M phase and cell apoptosis tended to increase slightly (P=0.067). The upregulation of YWHAZ and downregulation of E2F1 and its target genes might contribute to cell cycle arrest in G2/M phase and apoptosis. In addition, the ceRNA network, consisting of long noncoding RNAs, mRNAs and microRNAs, was established. Conclusion The T-long isoform was a risk factor and the T-short isoform was a protective factor for chordoma recurrence. In addition, the cell cycle was the main target of T isoforms knockdown, and the changes in the downstream transcriptome may contribute to the different effects of specific T isoform knockdown on the changes in the cell cycle distributions and apoptosis and proliferation of chordoma cells.
Collapse
Affiliation(s)
- Junpeng Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wei Chen
- Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Ke Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Kaibing Tian
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Li
- China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Tianna Zhao
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.,Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.,Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.,Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.,Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| |
Collapse
|
7
|
Prasad KN, Bondy SC. Increased oxidative stress, inflammation, and glutamate: Potential preventive and therapeutic targets for hearing disorders. Mech Ageing Dev 2019; 185:111191. [PMID: 31765645 DOI: 10.1016/j.mad.2019.111191] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/30/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022]
Abstract
Hearing disorders constitute one of the major health concerns in the USA. Decades of basic and clinical studies have identified numerous ototoxic agents and investigated their modes of action on the inner ear, utilizing tissue culture as well as animal and human models. Current preventive and therapeutic approaches are considered unsatisfactory. Therefore, additional modalities should be developed. Many studies suggest that increased levels of oxidative stress, chronic inflammation, and glutamate play an important role in the initiation and progression of damage to the inner ear leading to hearing impairments. To prevent these cellular deficits, antioxidants, anti-inflammatory agents, and antagonists of glutamate receptor have been used individually or in combination with limited success. It is essential, therefore, to simultaneously enhance the levels of antioxidant enzymes by activating the Nrf2 (a nuclear transcriptional factor) pathway, dietary and endogenous antioxidant compounds, and B12-vitamins in order to reduce the levels of oxidative stress, chronic inflammation, and glutamate at the same time. This review presents evidence to show that increased levels of these cellular metabolites, biochemical or factors are involved in the pathogenesis of cochlea leading to hearing impairments. It presents scientific rationale for the use of a mixture of micronutrients that may decrease the levels of oxidative damage, chronic inflammation, and glutamate at the same time. The benefits for using oral administration of proposed micronutrient mixture in humans are presented. Animal and limited human studies indirectly suggest that orally administered micronutrients can accumulate in the inner ear. Therefore, this route of administration may be useful in prevention, and in combination with standard care, in improved management of hearing problems following exposure to well-recognized and studied ototoxic agents, such as noise, cisplatin, aminoglycoside antibiotics, and advanced age.
Collapse
Affiliation(s)
- Kadar N Prasad
- Engage Global, 245 El Faisan Drive, San Rafael, CA, 94903, United States.
| | - Stephen C Bondy
- Center for Occupational and Environmental Health, Department of Medicine, University of California, Irvine, CA, 92697-1830, United States
| |
Collapse
|
8
|
Zhong H, Zhou Z, Lv GH, Li J, Zou MX. Letter to the Editor. Brachyury as prognostic biomarker in chordoma. J Neurosurg 2018; 129:273-275. [PMID: 29701545 DOI: 10.3171/2017.9.jns172108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Hua Zhong
- 1Central Hospital of Yi Yang, Yiyang, China; and
| | - Zhihong Zhou
- 1Central Hospital of Yi Yang, Yiyang, China; and
| | - Guo-Hua Lv
- 2The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- 2The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ming-Xiang Zou
- 2The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
9
|
Jian J, Zhong N, Jiang D, Li L, Lou Y, Zhou W, Chen S, Xiao J. The embryonic transcription factor Brachyury confers chordoma chemoresistance via upregulating CA9. Am J Transl Res 2018; 10:936-947. [PMID: 29636883 PMCID: PMC5883134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 02/21/2018] [Indexed: 06/08/2023]
Abstract
Being a rare malignant bone tumor on the axial skeleton, chordoma is locally invasive and has a high rate of recurrence. Despite extensive studies, the mechanisms of chordoma recurrence after surgical intervention, as well as resistance to radiation and chemotherapy, remain elusive. In this study, primary chordoma cell lines PCH1 and PCH2 were established and characterized by chordoma specific markers. We found that the embryonic transcription factor Brachyury inhibits Paclitaxel induced apoptosis in different cells, including PCH1 and U2OS cells. T gene regulated genes were identified in PCH1 and U2OS using microarray. After comparing gene regulated by Brachyury in different cells and the chromatin immunoprecipitation assay, we identified carbonic anhydrase IX (CA9) as a common target gene of Brachyury. Besides, immunohistochemical staining of CA9 and Brachyury in chordoma tissues revealed that their expression levels were positively correlated. We further showed that CA9 is responsible for Paclitaxel resistance in PCH1 cell. Our data suggest that CA9 plays a role in Brachyury mediated Paclitaxel resistance and serves as a potential target for chordoma treatment.
Collapse
Affiliation(s)
- Jiao Jian
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Nanzhe Zhong
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Dongjie Jiang
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Lei Li
- Institute of Biomedical Sciences and School of Life Sciences, East China Normal UniversityChina
| | - Yan Lou
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Wang Zhou
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Su Chen
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityShanghai, China
| |
Collapse
|
10
|
Immunophenotypic features of dedifferentiated skull base chordoma: An insight into the intratumoural heterogeneity. Contemp Oncol (Pozn) 2018; 21:267-273. [PMID: 29416431 PMCID: PMC5798418 DOI: 10.5114/wo.2017.72385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 08/26/2017] [Indexed: 01/05/2023] Open
Abstract
Chordomas are rare and low-grade malignant solid tumours, despite their histologically benign appearance, that arise in the bone from embryonic notochordal vestiges of the axial skeleton, a mesoderm-derived structure that is involved in the process of neurulation and embryonic development. Chordomas occurring in the skull base tend to arise in the basiocciput along the clivus. Three major morphological variants have been described (classical, chondroid, and atypical/dedifferentiated). The pathogenesis and molecular mechanisms involved in chordoma development remain uncertain. From a pathological standpoint, the microenvironment of a chordoma is heterogeneous, showing a dual epithelial-mesenchymal differentiation. These tumours are characterised by slow modality of biologic growth, local recurrence, low incidence of metastasis rates, and cancer stem cell (CSC) phenotype. The main molecular findings are connected with brachyury immunoexpression and activation of the downstream Akt and mTOR signalling pathways. The differentiation between typical and atypical chordomas is relevant because the tumoural microenvironment and prognosis are partially different. This review provides an insight into the recent and relevant concepts and histochemical markers expressed in chordomas, with special emphasis on dedifferentiated chordomas and their prognostic implications.
Collapse
|
11
|
Zou MX, Lv GH, Wang XB, Li J. Letter: Factors Predicting Recurrence after Resection of Clival Chordoma Using Variable Surgical Approaches and Radiation Modalities. Neurosurgery 2017; 81:E28-E31. [DOI: 10.1093/neuros/nyx136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
12
|
Expression of Cathepsin K in Skull Base Chordoma. World Neurosurg 2017; 101:396-404. [PMID: 28216213 DOI: 10.1016/j.wneu.2017.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 02/01/2017] [Accepted: 02/02/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study was to explore the association between cathepsin K and the clinical characteristics of skull base chordoma (SBC). METHODS This study included 58 paraffin-embedded samples and 85 frozen samples of 94 patients. All clinical data corresponding to these patients were available. Immunohistochemical staining and quantitative real-time polymerase chain reaction were performed. Positive rate of immunohistochemical staining slices and delta cycle threshold value of quantitative real-time polymerase chain reaction represented the cathepsin K expression level in protein and gene level separately. RESULTS In protein level, expression level (EL) of invasive tumors was increased compared with noninvasive tumors (P = 0.006), EL of tumors with dura erosion was increased compared with tumors without dura erosion (P = 0.001). Tumors with septa exhibited increased EL compared with tumors without septa (P = 0.001). Tumors with lobulation exhibited increased EL compared with tumors without lobulation (P = 0.000). Higher EL of cathepsin K was associated with reduced progression-free survival (PFS) (P = 0.015). In gene level, tumors with septa showed higher EL than tumors without septa (P = 0.015), and tumors with lobulation showed higher EL than tumors without lobulation (P = 0.049). Cathepsin K EL was an independent risk factor for reduced PFS, and an increased level of cathepsin K in SBC was associated with reduced PFS (P = 0.042). CONCLUSIONS Increased cathepsin K expression in SBC was associated with tumor invasion and reduced PFS. The cathepsin K level in SBC also was associated with tumor stage, tumor lobulation, and septa.
Collapse
|
13
|
Yang J, Yang X, Miao W, Jia Q, Wan W, Meng T, Wu Z, Cai X, Song D, Xiao J. Spine extra-osseous chordoma mimicking neurogenic tumors: report of three cases and review of the literatures. World J Surg Oncol 2016; 14:206. [PMID: 27491867 PMCID: PMC4973554 DOI: 10.1186/s12957-016-0951-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 07/14/2016] [Indexed: 11/23/2022] Open
Abstract
Background For a long time, chordoma has been known as an osseous tumor mainly found at the clivus and sacrococcygeal region. However, spine extra-osseous chordoma (SEC) with a better prognosis than the classic type has been neglected. According to our literature review, only several case reports have been published in English literatures. Here in this article, three cases of SEC, plus a literature review, are presented. Case presentation Three cases of SEC were presented from our center. Surprisingly, neurologic tumors were considered as the first diagnosis. Thereafter, en bloc resection was performed in all the three cases. Especially, the dumbbell-shaped one in the cervical spine was removed by en bloc through the combined anterior and posterior approach for the first time. Follow-up within 12–58 months after surgeries proved no recurrence or metastasis. Conclusions Spine extra-osseous chordoma, commonly located in the cervical and epidural region, is extremely rarely met. SEC is characterized with less aggressiveness, the lower rate of recurrence and metastasis, and better prognosis than those of the osseous origin. Though complete excision can be achieved generally, differential diagnosis of spine neurogenic tumors and the following en bloc resection should be made as carefully as possible.
Collapse
Affiliation(s)
- Jian Yang
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Xinghai Yang
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Wujun Miao
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Qi Jia
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Wei Wan
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Tong Meng
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Zhipeng Wu
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Xiaopan Cai
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China
| | - Dianwen Song
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
| | - Jianru Xiao
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
| |
Collapse
|
14
|
Wang K, Hu Q, Wang L, Chen W, Tian K, Cao C, Wu Z, Jia G, Zhang L, Zeng C, Zhang J. T gene isoform expression pattern is significantly different between chordomas and notochords. Biochem Biophys Res Commun 2015; 467:261-7. [DOI: 10.1016/j.bbrc.2015.09.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 09/29/2015] [Indexed: 01/11/2023]
|