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. 2015 May;17(5):725-32.
doi: 10.1093/neuonc/nou331. Epub 2014 Dec 8.

Clinical features and prognostic factors of patients with chordoma in the spine: a retrospective analysis of 153 patients in a single center

Tong Meng  1 , Huabin Yin  1 , Bo Li  1 , Zhenxi Li  1 , Wei Xu  1 , Wang Zhou  1 , Mo Cheng  1 , Jing Wang  1 , Lei Zhou  1 , Xinghai Yang  1 , Tielong Liu  1 , Wangjun Yan  1 , Dianwen Song  1 , Jianru Xiao  1
Affiliations

Clinical features and prognostic factors of patients with chordoma in the spine: a retrospective analysis of 153 patients in a single center

Tong Meng et al. Neuro Oncol. 2015 May.

Abstract

Background: Chordoma in the spine is relatively rare, and minimal information has been published in the literature regarding this subject. Moreover, there are controversies over prognostic factors of this disease.

Methods: A retrospective analysis of chordoma in the spine was performed by survival analysis. Local relapse-free survival (LRFS) and overall survival (OS) were analyzed from the date of surgery to the date of local recurrence and death. The LRFS and OS rates were estimated using the Kaplan-Meier method to identify potential prognostic factors. Factors with P values ≤ .1 were subjected to multivariate analysis by Cox regression analysis. P values ≤ .05 were considered statistically significant.

Results: A total of 153 patients with spinal chordoma were included in the study. The mean follow-up period was 72.0 months (range, 1-279 months). Local recurrence was detected in 51 cases after initial surgery in our center, while death occurred in 42 cases. The statistical analysis suggested that tumor location of C3-L5, dedifferentiated chordoma, preoperative Frankel scores A-C, and total spondylectomy were independent prognostic factors for LRFS. In addition, total en bloc spondylectomy and Karnofsky' performance status (KPS) ≥ 80% were favorable factors for OS.

Conclusions: Total spondylectomy, by either en bloc or piecemeal method, could significantly reduce LRFS for spinal chordoma. Location of C3-L5 is a favorable factor for LRFS, while dedifferentiated subtype and preoperative Frankel scores A-C are adverse prognostic factors. In addition, total en bloc spondylectomy and KPS ≥ 80% significantly improve overall survival of patients with spinal chordoma.

Keywords: chordoma; prognostic factor; spine tumor; surgery; survival.

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Figures

Fig. 1.
Fig. 1.
Patient flow diagram.
Fig. 2.
Fig. 2.
Kaplan–Meier curves of local relapse-free survival (LRFS) for (A) tumor location, (B) Frankel score, (C) pathological grade, and (D) resection mode.
Fig. 3.
Fig. 3.
Kaplan–Meier curves of overall survival for (A) KPS and (B) resection mode.
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