Primary Skull Base Chordomas: A Clinicopathological Analysis of 94 Patients.

Autor: Zhao L; Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Chang C; Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China., Zhuang Y; Department of Medical Oncology, Jiangsu Institute of Cancer Research, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China., Wang B; Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Qin L; Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Zheng JJ; Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China., You YP; Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Liu N; Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Ji J; Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Neurosurgery, The Affiliated Kizilsu Kirghiz Autonomous Prefecture People's Hospital of Nanjing Medical University, Artux, Xinjiang, China. Electronic address: jijing@njmu.edu.cn., Zheng K; Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2023 Jul; Vol. 175, pp. e841-e854. Date of Electronic Publication: 2023 Apr 15.
DOI: 10.1016/j.wneu.2023.04.032
Abstrakt: Objective: To investigate prognostic factors in patients with primary skull base chordoma (PSBC) to guide future therapeutic advances.
Methods: This retrospective cohort study of 94 PSBC patients was conducted in 2 institutions from January 2006 to December 2013. Independent predictors for progression-free survival (PFS) and overall survival were established with multivariate Cox regression analysis.
Results: Age (P = 0.006), extent of resection (P = 0.037), and radiotherapy (RT) (P = 0.027) were established as independent predictors for PFS in PSBC patients. Similarly, age (P = 0.002), extent of resection (P = 0.048), and RT (P = 0.015) were established as independent predictors for overall survival. Meta-analysis manifested that lower MIB-1 correlated with longer PFS in skull base chordoma patients (P < 0.001). RT doubled the 5-year PFS rate from 28.6 ± 12.1% to 61.6 ± 10.7% (P = 0.031) and increased the 5-year overall survival rate from 54.5 ± 13.8% to 84.2 ± 8.4% (P = 0.020) in the subtotal resection/partial resection and MIB-1 labeling index (STR/PR+MIB-1 LI) <2% subgroup. In contrast, in the STR/PR+MIB-1 LI ≥2% subgroup, the survival benefit of RT remained uncertain. Further analysis revealed no survival difference between different RT modalities in STR/PR PSBC patients.
Conclusions: In PSBC patients, age, extent of resection, and adjuvant RT all are independent predictors for PFS. Lower MIB-1 LI is associated with longer PFS in PSBC patients. Adjuvant RT is necessary for PSBC patients who undergo STR/PR with MIB-1 LI <2%. Patients who undergo GTR or STR/PR with MIB-1 LI ≥2% seem nonresponsive to RT.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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