Immunohistochemical markers predicting recurrence following resection and radiotherapy in chordoma patients: insights from a multicenter study [RETRACTED].

Autor:	Bon Nieves A; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota., Ghaith AK; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; Departments of2Neurological Surgery., El-Hajj VG; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; Departments of2Neurological Surgery., Akinduro OO; 3Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida., Ibrahim S; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; Departments of2Neurological Surgery., Ghanem M; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota., Goyal A; 3Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida., Otamendi-Lopez A; 3Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida., Nathani KR; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; Departments of2Neurological Surgery., Choby G; 4Otolaryngology-Head & Neck Surgery, and., Laack NN; 5Radiation Oncology, Mayo Clinic, Rochester, Minnesota; and., Link MJ; Departments of2Neurological Surgery., Peris Celda M; Departments of2Neurological Surgery., Van Gompel JJ; Departments of2Neurological Surgery., Quiñones-Hinojosa A; 5Radiation Oncology, Mayo Clinic, Rochester, Minnesota; and., Bydon M; 1Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota.; Departments of2Neurological Surgery., Pinheiro Neto C; 4Otolaryngology-Head & Neck Surgery, and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2023 Nov 10, pp. 1-7. Date of Electronic Publication: 2023 Nov 10.
DOI:	10.3171/2023.9.JNS23862
Abstrakt:	Objective: Chordomas are rare tumors that often recur regardless of surgery with negative margins and postoperative radiotherapy. The predictive accuracy of widely used immunohistochemical (IHC) markers in addressing the recurrence of skull base chordomas (SBCs) is yet to be determined. This study aimed to investigate IHC markers in the prediction of recurrence after SBC resection with adjuvant radiation therapy. Methods: The authors reviewed the records of patients who had treatment for SBC between January 2017 and June 2021 across the Mayo Clinic in Minnesota, Florida, and Arizona. Exclusion criteria included patients who had no histopathology or recurrence as an outcome. Histopathological markers included cytokeratin A1/A3 only, epithelial membrane antigen (EMA), S100 protein, pan-cytokeratin, IN1, GATA3, CAM5.2, OSCAR, and chondroid. Information from patient records was abstracted, including treatment, clinical and radiological follow-up duration, demographics, and histopathological factors. Decision tree and random forest classifiers were trained and tested to predict the recurrence based on unseen data using an 80/20 split. Results: A total of 38 patients with a diagnosis of SBC who underwent resection (gross-total resection: 42.1%; and subtotal resection: 57.9%) and radiation therapy were extracted from the medical records. The mean patient age was 48.2 (SD 19.6) years; most patients were male (n = 23; 60.5%) and White (n = 36; 94.7%). Pan-cytokeratin was associated with an increased risk of postoperative recurrence (OR 14.67, 95% CI 2.44-88.13; p = 0.00517) after resection and adjuvant radiotherapy. The decision tree analysis found pan-cytokeratin-positive tumors to have a 78% chance of being classified as a recurrence, with an accuracy of 75%. The distribution of minimal depth in the prediction of postoperative recurrence indicates that the most important variables were pan-cytokeratin, followed by cytokeratin A1/A3 and EMA. Conclusions: The authors' machine learning algorithm identified pan-cytokeratin as the largest contributor to recurrence among other IHC markers after SBC resection. Machine learning may facilitate the prediction of outcomes in rare tumors, such as chordomas.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu