Chordomas of the skull base, mobile spine, and sacrum: An epidemiologic investigation of presentation, treatment, and survival Journal Article
| Authors: | Zuckerman, S. L.; Bilsky, M. H.; Laufer, I. |
| Article Title: | Chordomas of the skull base, mobile spine, and sacrum: An epidemiologic investigation of presentation, treatment, and survival |
| Abstract: | Background: Chordomas are rare primary bone tumors that arise from the axial skeleton. Our objective was to analyze trends in radiation and surgery over time and determine location-based survival predictors for chordomas of the skull base, mobile spine, and sacrum. Methods: A retrospective cohort study of the SEER (Surveillance Epidemiology and End Results) database from 1973 to 2013 was conducted. All patients had histologically confirmed chordomas. The principal outcome measure was overall survival (OS). Results: The cohort included 1616 patients: skull base (664), mobile spine (444), and sacrum (508). Skull base tumors presented earliest in life (47.4 years) and sacral tumors presented latest (62.7 years). Rates of radiation remained stable for skull base and mobile spine tumors but declined for sacral tumors (P = 0.006). Rates of surgical resection remained stable for skull base and sacral tumors but declined for mobile spine tumors (P = 0.046). Skull base chordomas had the longest median survival (162 months) compared with mobile spine (94 months) and sacral tumors (87 months). Being married was independently associated with improved OS for skull base tumors (hazard ratio, 0.73; 95% confidence interval, 0.53–0.99; P = 0.044). Surgical resection was independently associated with improved OS for sacral chordomas (hazard ratio, 0.48; 95% confidence interval, 0.34–0.69; P < 0.001). Conclusions: Surgical resection for mobile spine chordomas and radiation for sacral chordomas decreased over time. Patients with skull base tumors survived longer than did patients with mobile spine and sacral chordomas, and surgical resection was associated with improved survival in sacral chordomas only. Understanding the behavior of these tumors can help cranial and spinal surgeons improve treatment in this patient population. © 2018 Elsevier Inc. |
| Keywords: | survival; adult; cancer survival; controlled study; treatment outcome; aged; middle aged; cancer surgery; survival rate; retrospective studies; young adult; major clinical study; overall survival; mortality; multimodality cancer therapy; cancer radiotherapy; cohort studies; cohort analysis; age factors; diagnostic imaging; periosteum; retrospective study; histology; age; spinal neoplasms; cancer registry; seer program; skull base; skull base neoplasms; epidemiology; skull base tumor; chordoma; sacrum; bone cancer; spine tumor; trends; mobile spine; epidemiologic studies; seer; spine cancer; humans; human; male; female; article |
| Journal Title: | World Neurosurgery |
| Volume: | 113 |
| ISSN: | 1878-8750 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-05-01 |
| Start Page: | e618 |
| End Page: | e627 |
| Language: | English |
| DOI: | 10.1016/j.wneu.2018.02.109 |
| PUBMED: | 29486315 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2018 -- Source: Scopus |
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