Sekhar Grading System for a Cranial Chordoma (SGSCC)

The Sekhar grading system can be used to describe the extent of a cranial chordoma. The authors are from the University of Washington in Seattle.

Patient selection: cranial chordoma

Parameters:

(1) tumor size (based on tumor equivalent diameter in cm)

(2) anatomic regions involved (site)

(3) vascular involvement

(4) intradural invasion

(5) tumor regrowth after prior surgery

(6) tumor regrowth after prior radiation therapy

tumor equivalent diameter =

= ((diameter 1) * (diameter 2) * (diameter 3))^(1/3)

Parameter	Finding	Points
tumor equivalent diameter	< 2.0 cm	1
	2 to 3.9 cm	2
	4.0 to 5.9 cm	3
	>= 6 cm	4
anatomic sites	upper clivus	1 (if involved, else 0)
	mid clivus	1 (if involved, else 0)
	lower clivus	1 (if involved, else 0)
	left cavernous sinus	1 (if involved, else 0)
	right cavernous sinus	1 (if involved, else 0)
	left cervical C1/C2/C3	1 (if involved, else 0)
	right cervical C1/C2/C3	1 (if involved, else 0)
vascular involvement	> 50% encasement left ICA	1 (if involved, else 0)
	> 50% encasement right ICA	1 (if involved, else 0)
	> 50% encasement left vertebral artery	1 (if involved, else 0)
	> 50% encasement right vertebral artery	1 (if involved, else 0)
	> 50% encasement basilar artery	1 (if involved, else 0)
intradural invasion	none	0
	small without brainstem involvement	1
	large with brainstem involvement	2
regrowth after surgery	no	0
	yes	2
regrowth after radiation	no	0
	yes	3

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 2

• maximum score: 25

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