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3. The sacral chordoma margin

Author

T. Steinmeier, Domenico Andrea Campanacci, Eugen B. Hug, Marco Gambarotti, G Marquina, Alessandro Luzzati, Akira Kawai, Ketti Mazzocco, A. P. Dei Tos, Josh Sommer, Luca Porcu, C Court, Giovanni Grignani, R Verges, R. Capanna, T. De Pas, P Georg, Paolo Bruzzi, Shreyaskumar Patel, Piera Navarria, Raphael E. Pollock, Beate Timmermann, Silvia Stacchiotti, Claudia Valverde, L Di Brina, Mateusz Spałek, Antonella Brunello, G M Scotto, Thomas F. DeLaney, Fabbri N, Paolo G. Casali, Patrick J. Boland, Anant Desai, Paolo Domenico Parchi, Riccardo Casadei, Peter Pal Varga, Susanne Scheipl, M. Fiore, Matthias Uhl, A Cordoba, Ferdinando Carlo Maria Cananzi, M G Petrongari, F. Navarria, J M Asencio, Toru Akiyama, Piero Fossati, Alessandro Gronchi, Robin L. Jones, Nadia Hindi, A. De Paoli, Stefano Radaelli, V Quagliuolo, A.M. Frezza, C Zoccali, Stéphanie Bolle, A Boglione, Augustinus D.G. Krol, J A Martin-Benlloch, Elisabetta Pennacchioli, Davide Maria Donati, Damien C. Weber, Stefano Bandiera, Alessandro Gasbarrini, Annalisa Trama, P. Picci, Claudia Sangalli, Øyvind S. Bruland, F. le Grange, Radaelli S., Fossati P., Stacchiotti S., Akiyama T., Asencio J.M., Bandiera S., Boglione A., Boland P., Bolle S., Bruland O., Brunello A., Bruzzi P., Campanacci D., Cananzi F., Capanna R., Casadei R., Cordoba A., Court C., Dei Tos A.P., DeLaney T.F., De Paoli A., De Pas T.M., Desai A., Di Brina L., Donati D.M., Fabbri N., Fiore M.R., Frezza A., Gambarotti M., Gasbarrini A., Georg P., Grignani G., Hindi N., Hug E.B., Jones R., Kawai A., Krol A.D., Le Grange F., Luzzati A., Marquina G., Martin-Benlloch J.A., Mazzocco K., Navarria F., Navarria P., Parchi P.D., Patel S., Pennacchioli E., Petrongari M.G., Picci P., Pollock R., Porcu L., Quagliuolo V., Sangalli C., Scheipl S., Scotto G.M., Spalek M., Steinmeier T., Timmermann B., Trama A., Uhl M., Valverde C., Varga P.P., Verges R., Weber D.C., Zoccali C., Casali P.G., Sommer J., and Gronchi A.

Subjects
musculoskeletal diseases, medicine.medical_specialty, Surgical margin, Sacrum, medicine.medical_treatment, Medizin, Sacral chordoma, 03 medical and health sciences, 0302 clinical medicine, medicine, Chordoma, Proton Therapy, Humans, Prospective cohort study, Radiation therapy, Surgery, Surgical margins, Particle therapy, business.industry, General surgery, Margins of Excision, Radiotherapy Dosage, General Medicine, medicine.disease, Primary tumor, Oncology, 030220 oncology & carcinogenesis, business, 030217 neurology & neurosurgery, Sacral Chordoma, Human
Abstract

Objective: Aim of the manuscript is to discuss how to improve margins in sacral chordoma.Background: Chordoma is a rare neoplasm, arising in half cases from the sacrum, with reported local failure in >50% after surgery.Methods: A multidisciplinary meeting of the "Chordoma Global Consensus Group" was held in Milan in 2017, focusing on challenges in defining and achieving optimal margins in chordoma with respect to surgery, definitive particle radiation therapy (RT) and medical therapies. This review aims to report on the outcome of the consensus meeting and to provide a summary of the most recent evidence in this field. Possible new ways forward, including on-going international clinical studies, are discussed.Results: En-bloc tumor-sacrum resection is the cornerstone of treatment of primary sacral chordoma, aiming to achieve negative microscopic margins. Radical definitive particle therapy seems to offer a similar outcome compared to surgery, although confirmation in comparative trials is lacking; besides there is still a certain degree of technical variability across institutions, corresponding to different fields of treatment and different tumor coverage. To address some of these questions, a prospective, randomized international study comparing surgery versus definitive high-dose RT is ongoing. Available data do not support the routine use of any medical therapy as (neo)adjuvant/cytoreductive treatment.Conclusion: Given the significant influence of margins status on local control in patients with primary localized sacral chordoma, the clear definition of adequate margins and a standard local approach across institutions for both surgery and particle RT is vital for improving the management of these patients. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Published
2020

4. LA SOCIETA' PER AZIONI - PROFILI GENERALI

Author

E. BERTACCHINI, L. CALVOSA, D. CATERINO, L. DE ANGELIS, L. DI BRINA, G. DI CECCO, S. FORTUNATO, G. MARTINA, S. PACCHI, U. PATRONI GRIFFI, A. PIRAS, N. RONDINONE, F. SCANNICCHIO, G. SCOGNAMMIGLIO, A. TUCCI, A. URBANI, G. VOLPE PUTZOLU, MARIA CECILIA CARDARELLI, LORENZO DE ANGELIS (A CURA DI), Bertacchini, E., Calvosa, L., Caterino, D., DE ANGELIS, L., DI BRINA, L., DI CECCO, G., Fortunato, S., Martina, G., Pacchi, S., PATRONI GRIFFI, U., Piras, A., Rondinone, N., Scannicchio, F., Scognammiglio, G., Tucci, A., Urbani, A., VOLPE PUTZOLU, G., and Cardarelli, Maria Cecilia

Subjects
SOCIETÀ PER AZIONI - RESPONSABILITA' LIMITATA - PARTECIPAZIONE SOCIALE - CAPITALE SOCIALE - SOCIETA' APERTE - SOCIETA' CHIUSE - SOCIETA' DI DIRITTO SPECIALE
Published
2017

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