EP.TH.359Improved Oesophagogastric Cancer Outcomes in Rural Patients

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Fiona Griffin ◽  
Ross Hunter ◽  
Shayanthan Nanthakumaran ◽  
George Ramsay
Keyword(s):  
Gastric Cancer ◽  
Performance Status ◽  
Surgical Techniques ◽  
Cancer Outcomes ◽  
Observation Study ◽  
Significant Difference ◽  
Rural Access ◽  
Rural Dwellers ◽  
Rural Patients ◽  
Oesophagogastric Cancer

Abstract Introduction Despite advances in medical therapies and surgical techniques, oesophagogastric cancer survival remains low. Poorer cancer outcomes and survival for rural dwellers is well documented worldwide and has been an area of focus in Scotland since 2007, with changes to suspected cancer referral guidelines and a government report on delivering remote and rural healthcare. Methods A prospective, single-centre observation study was conducted utilising data from oesophago-gastric cancer MDT referrals and outcomes from January 2013 to December 2019. The Scottish Index of Multiple Deprivation 2020 tool provided a rurality code based on patient postcode at time of referral. Survival outcomes for urban and rural patients were compared across demographic factors, disease factors and stage at presentation. Results 1046 patients were included in this study. The median age of presentation for urban and rural patients was 73.7 and 72.4 respectively. There was no significant difference between oesophageal versus gastric cancer presentations nor was there any difference between T, N or M stage at presentation between the groups. No difference was identified between those commenced on a radical therapy with other treatment plans. On Kaplan-Meier analysis there was a difference in survival between the groups favouring rural dwellers (p = 0.012). Discussion The difference in survival demonstrated here between urban and rural groups is not easily explained but may represent improvements to rural access to healthcare delivered as a result of policy change. This is an interesting finding and this study should be expanded to include performance status at time of referral.

SP7.1.11 Deprivation has No Effect on Oesophagogastric Cancer Outcomes in North of Scotland

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ross Hunter ◽  
Fiona Griffin ◽  
Shayanthan Nanthakumaran ◽  
George Ramsay
Keyword(s):  
Gastric Cancer ◽  
Cancer Survival ◽  
Surgical Techniques ◽  
Observation Study ◽  
North East ◽  
Affluent Area ◽  
Significant Difference ◽  
Radical Therapy ◽  
Treatment Plans ◽  
Oesophagogastric Cancer

Abstract Introduction Despite advances in medical therapies and surgical techniques, oesophagogastric cancer survival remains low. Poorer survival and outcomes from colorectal cancer have been reported for patients living in areas of higher socioeconomic deprivation1. Our aim was to determine if deprivation affected oesophagogastric cancer survival in North East of Scotland. Methods A prospective, single-centre observation study was conducted utilising data from oesophago-gastric cancer MDT referrals and outcomes from January 2013 to December 2019. Patient postcodes were cross-referenced with the Scottish Index of Multiple Deprivation (SIMD) 2020 tool which provided a level of deprivation for each address. Survival outcomes were compared across demographic factors, disease factors and stage at presentation across deprivation quintiles. Results 1046 patients were included in this study. There were fewer patients in the most deprived (1st) quintile (n = 65) than in the least deprived (5th) quintile (n = 245). There was no significant difference between oesophageal versus gastric cancer presentations nor was there any difference between T, N or M stage at presentation between the most and least deprived groups. No difference was identified between those commenced on a radical therapy with other treatment plans. No difference in survival time was noted between the groups. Discussion No difference in survival was demonstrated across areas of deprivation within this catchment area. However, Aberdeenshire is an affluent area with less overall deprivation compared with other areas of Scotland.

scholarly journals Efficacy of Brucea javanica Oil Emulsion Injection Combined with the Chemotherapy for Treating Gastric Cancer: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jia-Rui Wu ◽  
Shu-Yu Liu ◽  
Jia-Lian Zhu ◽  
Dan Zhang ◽  
Kai-Huan Wang
Keyword(s):  
Gastric Cancer ◽  
Total Effective Rate ◽  
Meta Analysis ◽  
Performance Status ◽  
Effective Rate ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Oil Emulsion ◽  
Brucea Javanica ◽  
Significant Difference

Objective. This meta-analysis sought to assess the efficacy and safety of Brucea javanica oil emulsion injection (BJOEI) combined with chemotherapy for treating gastric cancer (GC). Method. Randomized controlled trials (RCTs) regarding BJOEI to treat GC were searched in PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, China Science and Technology Journal Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to January 9, 2017. The clinical total effective rate, performance status, adverse drug reactions (ADRs), and other outcomes were analyzed with Review Manager 5.3 and Stata12.0 software. Results. 13 RCTs involving 912 patients were included in the present meta-analysis. The results demonstrated that, compared with receiving chemotherapy alone, BJOEI combined with chemotherapy was more effective in improving clinical total effective rate (RR = 1.38, 95% CI: 1.22~1.56, P<0.00001), performance status (RR = 1.63, 95% CI: 1.30~2.04, P<0.00001), and relieving ADRs such as myelosuppression, neutropenia, thrombopenia, and liver damage. Statistically significant difference was observed between the experimental group and control group. Conclusion. The pooled analysis showed that using BJOEI on the basis of the chemotherapy had a remarkable therapeutic effect for patients with GC, whereas more evidence-based medical researches were required to further support our study.

Optimal indications for palliative chemotherapy in elderly patients with metastatic or recurrent gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 207-207
Author(s):  
Hiroko Hasegawa ◽  
Kazumasa Fujitani ◽  
Aya Sugimoto ◽  
Shoichi Nakazuru ◽  
Motohiro Hirao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Elderly Patients ◽  
Primary Tumor ◽  
Multivariate Analyses ◽  
Performance Status ◽  
First Line ◽  
Recurrent Gastric Cancer ◽  
Significant Difference ◽  
Line Chemotherapy

207 Background: Gastric cancer is the second causes of cancer-related deaths in the world and its incidence of advanced gastric cancer (AGC) in the elderly is increasing as a result of increased life expectancy. However, elderly patients have been underrepresented in many kinds of chemotherapy clinical trials. Therefore it is difficult to evaluate the efficacy and safety of chemotherapy for elderly patients and select the appropriate patients aged 70 years or older who are likely to benefit from the chemotherapy. Methods: There were 265 patients with primary unresectable or recurrent gastric cancer treated at our institution between April 2007 and March 2014. Of all, 90 patients aged 70 years or older were retrospectively identified. We evaluated the efficacy of the chemotherapy and prognostic significance of clinico-pathologic factors to identify the optimal indications for chemotherapy. Univariate and multivariate analyses were perfomed on the base-line characteristics such as patient’s performance status (PS), gender, chemotherapy regimens, history of gastrectomy, presense of co-morbidity, serum LDH level, serum C reactive protein, and nutritional status, at the initiation of the first-line chemotherapy. Results: The median overall survival time (OS) was 343 days and the median TTF on first-line chemotherapy was 111 days. The toxicity was mild and tolerable. There were no significant difference in overall survival between patients receiving monotherapy and combination therapy. On multivariate analyses, PS 1 or 2 (hazard ratio (HR), 1.883; 95% confidence interval (CI), 1.047–3.390), presence of primary tumor (HR, 1.916; 95% CI, 1.063–3.448) at the initiation of the first- line chemotherapy were identified as significant independent poor prognostic factors for overall survival. Especially in patients aged 75 years or older, only PS was an independent prognostic factor for OS (HR, 3.703; 95% CI, 1.314–9.900). Conclusions: Analysis of our results shows that patients aged 70 years or older with good performance status and absence of primary tumor might achieve clinical benefit from chemotherapy.

Does capecitabine plus cisplatin (XP) give advanced or recurrent gastric cancer (AGC) patients higher early tumor shrinkage (ETS) rate than S1 plus cisplatin (SP) with safety?

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 172-172
Author(s):  
Naotoshi Sugimoto ◽  
Tetsuhiro Yoshinami ◽  
Sachiko Yamamoto ◽  
Toshinari Yagi ◽  
Fumio Imamura
Keyword(s):  
Gastric Cancer ◽  
Intravenous Infusion ◽  
Performance Status ◽  
Treatment Guideline ◽  
Oral Intake ◽  
Progression Free Survival ◽  
Tumor Shrinkage ◽  
Significant Difference ◽  
Early Tumor ◽  
Line Setting

172 Background: Capecitabine plus cisplatin (XP) is defined as the platform regimen in many global trials (ex: ToGA, AVAGAST) for AGC in first-line setting. But in the Japanese Gastric Cancer Treatment Guideline (4th edition), S-1 plus cisplatin (SP) is mentioned the standard (recommendation 1), XP is considered as recommendation 2. Few reports were existed about the comparison between XP and SP. So we retrospectively compared the efficacy and toxicity of XP and SP for patients with AGC in our hospital. Methods: The selection criteria were pathologically proven AGC (HER2 negative or unknown); no previous chemotherapy; performance status 0-2; able to oral intake; and adequate organ functions. The patients in XP group, capecitabine 1,000mg/m2 was given orally twice daily for 14days followed by a 7-day rest; cisplatin 80mg/m2 on day1 was given by intravenous infusion. In SP group, S1 40mg/m2 was given orally twice daily for 21 days followed by a 14-day rest and cisplatin 60mg/m2 intravenous infusion on day8. Results: The analysis covered 115 patients over the period from May 2008 to June 2014. The median age was 64 years (range 22-81); 76 males and 39 females; PS 0/1/2 score 85/29/1; 31 patients were treated XP and 84 patients were treated SP. Progression-free survival and overall survival were 6.6 and 16.4 months with XP and 6.1 and 13.3 months with SP (no significant difference). The response rates were XP/SP 61%/50%. The ETS (over 20% tumor shrinkage in 6-8weeks) rate were 83% in XP and 61% in SP (p=0.09). The rate of grade 3-4 toxicity in XP/SP were; neutropenia 23%/15%, anemia 16%/20%, nausea 0%/3%, anorexia 3%/ 8%, fatigue 0%/ 4%, hyponatremia 3%/ 0%. There was no treatment death in both groups. Conclusions: It is suggested that XP give AGC patients high ETS rate with safety.

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

2016 ◽  
Vol 25 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Kunihiko Izuishi ◽  
Hirohito Mori
Keyword(s):  
Gastric Cancer ◽  
Performance Status ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Palliative Gastrectomy ◽  
Advanced Tumor ◽  
Esophagogastric Cancer ◽  
Previously Treated

Recently, many strategies have been reported for the effective treatment of gastric cancer. However, the strategy for treating stage IV gastric cancer remains controversial. Conducting a prospective phase III study in stage IV cancer patients is difficult because of heterogeneous performance status, age, and degree of cancer metastasis or extension. Due to poor prognosis, the variance in physical status, and severe symptoms, it is important to determine the optimal strategy for treating each individual stage IV patient. In the past decade, many reports have addressed topics related to stage IV gastric cancer: the 7th Union for International Cancer Control (UICC) TNM staging system has altered its stage IV classification; new chemotherapy regimens have been developed through the randomized ECF for advanced and locally advanced esophagogastric cancer (REAL)-II, S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer (SPIRITS), trastuzumab for gastric cancer (ToGA), ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD), and ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW) trials; and the survival efficacy of palliative gastrectomy has been denied by the reductive gastrectomy for advanced tumor in three Asian countries (REGATTA) trial. Current strategies for treating stage IV patients can be roughly divided into the following five categories: palliative gastrectomy, chemotherapy, radiotherapy, gastric stent, or bypass. In this article, we review recent publications and guidelines along with above categories in the light of individual symptoms and prognosis. Abbreviations: APC: argon plasma coagulation; AVAGAST: anti-angiogenic antibody bevacizumab, the avastin in gastric cancer; BSC: best supportive care; CF: cisplatin and fluorouracil; CRP: C-reactive protein; DCF: docetaxel, cisplatin, and 5-FU; FISH: fluorescent in-situ hybridization; GJ: gastrojejunostomy; GPS: Glasgow Prognostic Score; HER: human epidermal growth factor receptor; HR: hazard ratio; NLR: neutrophil-to-lymphocyte ratio; OS: overall survival; PS: performance status; QOL: quality of life; RAINBOW: ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; RCTs: randomized controlled trials; REAL: randomized ECF for advanced and locally advanced esophagogastric cancer; REGARD: ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; REGATTA: reductive gastrectomy for advanced tumor in three Asian countries; SEER: Surveillance Epidemiology and End Results; SEMS: self-expandable metal stents; SPIRITS: S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer; ToGA: trastuzumab for gastric cancer; TTP: time-to-progression; VEGFR: vascular endothelial growth factor receptor.

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

scholarly journals Laparoscopic proximal gastrectomy with double-tract reconstruction for upper third gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuo-meng Xiao ◽  
Ping Zhao ◽  
Zhi Ding ◽  
Rui Xu ◽  
Chao Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Operation Time ◽  
Nutrition Status ◽  
Proximal Gastric Cancer ◽  
Double Tract Reconstruction ◽  
Significant Difference ◽  
Laparoscopic Proximal Gastrectomy ◽  
Gastric Cancer Patients ◽  
Upper Third

Abstract Background Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer. Methods Sixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively. Results The operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups. Conclusion LPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.

scholarly journals Measurement of femoral posterior condylar offset and posterior tibial slope in normal knees based on 3D reconstruction

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liangxiao Bao ◽  
Shengwei Rong ◽  
Zhanjun Shi ◽  
Jian Wang ◽  
Yang Zhang
Keyword(s):  
Three Dimensional ◽  
Surgical Techniques ◽  
Inverse Correlation ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Lateral Side ◽  
Posterior Condylar Offset ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Posterior Condylar

Abstract Background Femoral posterior condylar offset (PCO) and posterior tibial slope (PTS) are important for postoperative range of motion after total knee arthroplasty (TKA). However, normative data of PCO and PTS and the correlation between them among healthy populations remain to be elucidated. The purpose of this study was to determine PCO and PTS in normal knees, and to identify the correlation between them. Methods Eighty healthy volunteers were recruited. CT scans were performed followed by three-dimensional reconstruction. PCO and PTS were measured and analyzed, as well as the correlation between them. Results PTS averaged 6.78° and 6.11°, on the medial and lateral side respectively (P = 0.002). Medial PCO was greater than lateral (29.2 vs. 23.8 mm, P <  0.001). Both medial and lateral PCO of male were larger than female. On the contrary, male medial PTS was smaller than female, while there was no significant difference of lateral PTS between genders. There was an inverse correlation between medial PCO and PTS, but not lateral. Conclusions Significant differences exhibited between medial and lateral compartments, genders, and among individuals. An inverse correlation exists between PCO and PTS in the medial compartment. These results improve our understanding of the morphology and biomechanics of normal knees, and subsequently for optimising prosthetic design and surgical techniques.

Randomized Trial of Adjuvant Chemotherapy With Mitomycin, Fluorouracil, and Cytosine Arabinoside Followed by Oral Fluorouracil in Serosa-Negative Gastric Cancer: Japan Clinical Oncology Group 9206–1

2003 ◽  
Vol 21 (12) ◽  
pp. 2282-2287 ◽  
Author(s):  
Atsushi Nashimoto ◽  
Toshifusa Nakajima ◽  
Hiroshi Furukawa ◽  
Masatsugu Kitamura ◽  
Taira Kinoshita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Survival Benefit ◽  
Curative Resection ◽  
Cancer Recurrence ◽  
Phase Iii ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Significant Difference

Purpose: To evaluate the survival benefit of adjuvant chemotherapy after curative resection in serosa-negative gastric cancer patients (excluding patients who were T1N0), we conducted a multicenter phase III clinical trial in which 13 cancer centers in Japan participated. Patients and Methods: From January 1993 to December 1994, 252 patients were enrolled into the study and allocated randomly to adjuvant chemotherapy or surgery alone. The chemotherapy comprised intravenous mitomycin 1.33 mg/m2, fluorouracil (FU) 166.7 mg/m2, and cytarabine 13.3 mg/m2 twice weekly for the first 3 weeks after surgery, and oral FU 134 mg/m2 daily for the next 18 months for a total dose of 67 g/m2. The primary end point was relapse-free survival. Overall survival and the site of recurrence were secondary end points. Results: Ninety-eight percent of patients underwent gastrectomy with D2 or greater lymph node dissection. There were no treatment-related deaths and few serious adverse events. There was no significant difference in relapse-free and overall survival between the arms (5-year relapse-free survival 88.8% chemotherapy v 83.7% surgery alone; P = .14 and 5-year survival 91.2% chemotherapy v 86.1% surgery alone; P = .13, respectively). Nine patients (7.1%) in the chemotherapy arm and 17 patients (13.8%) in the surgery-alone arm had cancer recurrence. Conclusion: There was no statistically significant relapse-free or overall survival benefit with this adjuvant chemotherapy for patients with macroscopically serosa-negative gastric cancer after curative resection, and there was no statistical difference between the two arms relating to the types of cancer recurrence. We do not recommend adjuvant chemotherapy with this regimen for this population in clinical practice.

scholarly journals Mobile spine chordoma: results of 166 patients from the AOSpine Knowledge Forum Tumor database

2016 ◽  
Vol 24 (4) ◽  
pp. 644-651 ◽  
Author(s):  
Ziya L. Gokaslan ◽  
Patricia L. Zadnik ◽  
Daniel M. Sciubba ◽  
Niccole Germscheid ◽  
C. Rory Goodwin ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Survival Data ◽  
Large Scale ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Increased Risk ◽  
Significant Difference ◽  
Mobile Spine

OBJECT A chordoma is an indolent primary spinal tumor that has devastating effects on the patient's life. These lesions are chemoresistant, resistant to conventional radiotherapy, and moderately sensitive to proton therapy; however, en bloc resection remains the preferred treatment for optimizing patient outcomes. While multiple small and largely retrospective studies have investigated the outcomes following en bloc resection of chordomas in the sacrum, there have been few large-scale studies on patients with chordomas of the mobile spine. The goal of this study was to review the outcomes of surgically treated patients with mobile spine chordomas at multiple international centers with respect to local recurrence and survival. This multiinstitutional retrospective study collected data between 1988 and 2012 about prognosis-predicting factors, including various clinical characteristics and surgical techniques for mobile spine chordoma. Tumors were classified according to the Enneking principles and analyzed in 2 treatment cohorts: Enneking-appropriate (EA) and Enneking-inappropriate (EI) cohorts. Patients were categorized as EA when the final pathological assessment of the margin matched the Enneking recommendation; otherwise, they were categorized as EI. METHODS Descriptive statistics were used to summarize the data (Student t-test, chi-square, and Fisher exact tests). Recurrence and survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariate Cox proportional hazard modeling. RESULTS A total of 166 patients (55 female and 111 male patients) with mobile spine chordoma were included. The median patient follow-up was 2.6 years (range 1 day to 22.5 years). Fifty-eight (41%) patients were EA and 84 (59%) patients were EI. The type of biopsy (p < 0.001), spinal location (p = 0.018), and if the patient received adjuvant therapy (p < 0.001) were significantly different between the 2 cohorts. Overall, 58 (35%) patients developed local recurrence and 57 (34%) patients died. Median survival was 7.0 years postoperative: 8.4 years postoperative for EA patients and 6.4 years postoperative for EI patients (p = 0.023). The multivariate analysis showed that the EI cohort was significantly associated with an increased risk of local recurrence in comparison with the EA cohort (HR 7.02; 95% CI 2.96–16.6; p < 0.001), although no significant difference in survival was observed. CONCLUSIONS EA resection plays a major role in decreasing the risk for local recurrence in patients with chordoma of the mobile spine.

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