Factors for overall survival in patients with skull base chordoma: a retrospective analysis of 225 patients.

Factors for overall survival in patients with skull base chordoma: a retrospective analysis of 225 patients.

World Neurosurg. 2016 Sep 23;

Authors: Tian K, Zhang H, Ma J, Wang K, Ru X, Du J, Jia G, Zhang L, Wu Z, Zhang J, Wang L

Abstract
BACKGROUND: Although being a controversial and complex issue, the prognostic factors of skull base chordomas are worth exploring.
METHODS: Prognostic factors associated with overall survival (OS) were retrospectively estimated on an individual cohort of skull base chordomas prospectively maintained for ten years by Kaplan-Meier method and univariate Cox proportional hazards model. Multivariate analysis by Cox regression analysis was performed to identify the independent prognostic factors. Then a nomogram was formulated by R software based on the above results.
RESULTS: A total of 180 primary patients and 45 recurrent cases were included, with a mean follow-up period of 43.7 months (range, 4-127 months). The OS rates of primary group at 5-year and 7-year were 84% and 78%, and its mean OS time was 103.8 months, that was significantly longer than the recurrent group, in which the mean post-recurrent OS time was 68.4 months. In primary group, preoperative Karnofsky' performance status (KPS) score (p=.004) and a decline of perioperative KPS score (p=.015) were identified as independent predictors of OS. A nomogram was contracted to predict 5-year, 7-year OS, which was well calibrated and had good discriminative ability (adjusted Harrell C statistic, 0.74). In recurrent group, visual deficit was verified as an independent risk factor associated with post-recurrent OS (p=.014).
CONCLUSIONS: Both pathological and perioperative KPS score evaluations own significance in OS prediction of both primary and recurrent cases. The nomogram for primary lesions, consisted of preoperative functional status and its perioperative changes, appears useful for risk stratification of long-term survival.

PMID: 27671886 [PubMed - as supplied by publisher]

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