Evidence map›Paper›PMID 40402197›Full record

ArticleJournal of neuro-oncology2025

Exploring perspectives on skull base chordoma management: a modified Delphi approach to consensus.

Saket Myneni, A Karim Ahmed, Foad Kazemi, Anirudh Saraswathula, Nathan T Zwagerman, Shirley Y Su, Garret Choby, Eric W Wang, Jamie J Van Gompel, Kristin J Redmond and 5 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Saket MyneniDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
A Karim AhmedDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
Foad KazemiDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
Anirudh SaraswathulaDepartment of Otolaryngology- Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
Nathan T ZwagermanDepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Shirley Y SuDepartment of Otolaryngology- Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA.
Garret ChobyDepartment of Otolaryngology- Head & Neck Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Eric W WangDepartment of Otolaryngology- Head & Neck Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Jamie J Van GompelDepartment of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Kristin J RedmondDepartment of Radiation Oncology, Johns Hopkins University, Baltimore, MD, USA.
Erin L McKeanDepartment of Otolaryngology- Head & Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
Carl H SnydermanDepartment of Otolaryngology- Head & Neck Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Paul A GardnerDepartment of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA.
Nicholas R RowanDepartment of Otolaryngology- Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
Debraj MukherjeeDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA. dmukher1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCurrent treatment for skull base chordomas utilizes both surgical resection and adjuvant radiation, but recent studies have demonstrated evidence that has brought the use of adjuvant radiotherapy into question. Chordomas differ greatly in molecular makeup and proliferation. These factors have led to significant variation in management across providers. We used a modified Delphi approach to work towards consensus on standardized operative definitions and evidence-based management of chordomas.

methodsOur multidisciplinary panel included participants representing the AANS/CNS Tumor Section and North American Skull Base Society (NASBS) with a track record of publishing on chordoma management. Our approach involved a four-step process: one statement-generation round, two voting rounds to establish consensus and refine statements, and a final external validation round by NASBS members. Anonymous voting was completed via Qualtrics surveys.

resultsThe statement-generation process produced 65 statements. Through the Delphi process, 36 statements reached consensus during the first round and an additional 17 were refined for further consensus in the second round. Moderate (67-80%) or strong (> 80%) consensus was achieved for 43 final statements. Forty-one items were externally validated. There was consensus that an endoscopic endonasal approach should be utilized whenever possible. They defined the tumor characteristics (molecular and cytogenic) to consider before offering adjuvant radiotherapy.

conclusionsThis modified Delphi study generated consensus on 41 statements regarding skull base chordoma management. These statements aim to shed light on the consensus among providers regarding the use of surgery, neoadjuvant radiation, adjuvant radiation, adjuvant systemic therapies, and treatment of recurrence for chordoma.

Indexed as

ChordomaSkull Base NeoplasmsDelphi TechniqueDisease ManagementHumansChordomaDelphiManagementOncologyResectionSkull base

Identifiers

PMID40402197

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.