Article Figures & Data
Figures
- FIG 1.
The electron microscopic features of the 2 classifications for skull base chordomas in low-power fields (×2500). A, In a cell-dense type chordoma, the physaliphorous cells are relatively tightly arranged and there is little extracellular matrix present. The vacuoles are not as rich as those observed in matrix-rich type tumor cells. The nuclei vary in size and condensed nuclei are found. B, In a matrix-rich type chordoma, the physaliphorous cells are sparse, and abundant extracellular matrix contents exist. The vacuoles are rich and apparent. The nuclei are slightly atypical.
- FIG 2.
Representative MR images of the 2 classified chordomas. A and B, The cell-dense type chordomas. A, T2-weighted MR imaging shows a low signal intensity, recurrent chordoma in the clival region. B, Contrast-enhanced MR imaging shows the lesion with marked enhancement. C and D, Matrix-rich type chordomas with high signal intensity on T2-weighted images and low signal intensity on contrast-enhanced MR imaging, respectively.
- FIG 3.
Kaplan-Meier analysis illustrating PFS and OS of 32 patients with chordomas without adjuvant radiation therapy. A, The patients with matrix-rich type chordomas have a significantly longer PFS than the patients with cell-dense type chordomas (P = .003). B, The OS of patients with matrix-rich type chordomas is significantly longer than that of those with cell-dense type chordomas (P = .002).
Tables
- Table 1:
Key points for the differential diagnosis of cell-dense and matrix-rich types according to the ultrastructures of chordomasa
Cell-Dense Type Matrix-Rich Type Tumor cell content in a low-power field (×3000) Densely arranged Seldom or none Extracellular matrix content Relatively sparse Abundant Complex of rough endoplasmic reticulum and the mitochondria Rich Relatively seldom Nuclei and chromatin Abnormal nuclei with condensed, deeply staining heterochromatin Regularly shaped nuclei, mainly with loosely arranged euchromatin Cell junctions Desmosomes are obvious Few desmosomes Collagen fibrils Type III collagen fibrils can be found Seldom Exocytosis Easily found Seldom ↵a Reprinted with permission from Bai et al13 and Elsevier.
- Table 2:
Demographics of the 79 patients undergoing chordoma surgery in Beijing Tiantan Hospital between July 2012 and July 2016
Total MRT CDT P No. of cases 79 39 40 Tumor status Primary 37 24 13 .01 Recurrent 42 15 27 Sex Male 43 21 22 .918 Female 36 18 18 Age (mean) (yr) Primary 47.8 ± 17.4 42.3 ± 18.2 58.2 ± 9.97 .006 Recurrent 47.1 ± 15.3 46.5 ± 16.5 47.6 ± 14.9 .828 Total 47.5 ± 16.2 43.9 ± 17.5 51.0 ± 14.3 .050 Histopathology Conventional 71 35 36 1.000 Chondroid 8 4 4 Blood supplya Rich 21 7 14 .073 Not rich 55 31 24 Resection grade ≥90% 43 23 20 .423 <90% 36 16 20 Survival status Alive 42 27 15 .018 Died 26 8 18 NAb 11 4 7 Presurgery radiation therapy Yes 17 5 12 .063 No 62 34 28 Postsurgery radiation therapy Yes 30 14 16 .667 No 43 21 22 NAc 6 4 2 PFS (mo)d 40.3 ± 5.4 52.2 ± 5.7 18.7 ± 6.9 .003 OS (mo) 100.5 ± 7.1 113.9 ± 6.3 88.9 ± 9.3 .018 Note:—NA indicates not applicable.
↵a Operative notes on 3 cases showed no specified blood supply.
↵b Including both patients lost to follow-up and patients who did not die of chordomas.
↵c Including the patients whose radiation therapy information was not available.
↵d Patients without radiation therapy (n = 32).
Surgery No./Electron Microscopic Classification Tumor Statusa No. of Cases 1 Operation (n = 65) CDT Primary 6 Recurrent 23 MRT Primary 22 Recurrent 14 2 Operations (n = 12) Both CDTs Primary 3 Recurrent 3 Both MRTs Primary 3 Recurrent 0 First MRT, second CDT Primary 1 Recurrent 1 First CDT, second MRT Primary 1 Recurrent 0 3 Operations (n = 2) 3 CDTs Primary 1 Recurrent 0 2 CDTs, 1 MRTb Primary 0 Recurrent 1 Signal Intensity Ratio Electron Microscopic Classification P CDT MRT Entire cohort (n = 95) RT2 1.90 ± 0.38 2.61 ± 0.60 <.001 RT1 0.63 ± 0.14 0.56 ± 0.13 .016 REN 1.19 ± 0.42 0.99 ± 0.41 .022 Primary tumors (n = 37) RT2 1.99 ± 0.39 2.69 ± 0.53 <.001 RT1 0.67 ± 0.18 0.55 ± 0.13 .019 REN 1.17 ± 0.42 0.89 ± 0.32 .024 Recurrent tumors (n = 58) RT2 1.87 ± 0.38 2.50 ± 0.67 .001 RT1 0.62 ± 0.13 0.58 ± 0.13 .307 REN 1.19 ± 0.43 1.11 ± 0.49 .526
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