Clival chordomas and chondrosarcomas in Denmark-Outcomes in 33 patients following the national centralization of treatment in 2010

Abstract

Purpose: This 13-year consecutive case series aims to provide a comprehensive overview of all patients operated for clival chordomas and clival chondrosarcomas in Denmark since the centralization of treatment in 2010, comparing outcomes to international series.

Methods: This was a retrospective review of 33 patients with clival tumors, comprising 22 chordomas and 11 chondrosarcomas, who were treated at Copenhagen University Hospital between years 2010 and 2023. Data were collected from digital patient records and pathology reports.

Results: The symptoms leading to diagnosis primarily included double vision, headaches, and dizziness. In general, patients were in good health, with a mean Charlson Comorbidity Index score of 1.6. The complication rate of the index surgery was 51.5%. Adjuvant radiotherapy was applied in 51.5% of the cases. In patients with clival chordomas, the mean age was 51.1 years, ranging from 16 to 83 years. At the time of diagnosis, the mean tumor volume was 20.9 cm³ and the five-year overall survival rates were 79.1% (95% confidence interval (CI): 62.4-100). In patients with chondrosarcomas, the mean age was 48.2 years, ranging from 15 to 76 years. At the time of diagnosis, the mean tumor volume was 22.3 cm³ and the five-year overall survival 90% (95% CI: 73.2-100).

Conclusion: The centralized treatment of clival tumors in Denmark demonstrates incidence, survival, and complication rates comparable to those found in other international series. Given the variations in treatment strategies, tumor localizations across series, and small sample sizes, the further analysis of larger compiled multicenter datasets for clival tumors could provide more solid evidence regarding the management of these rare tumors.

Keywords: Adjuvant radiotherapy; Chondrosarcoma; Chordoma; Clival.

Fig. 1

Kaplan–Meier survival analysis depicting overall survival for chordoma patients with 95% confidence intervals (grey shading)

Fig. 2

Kaplan–Meier survival analysis depicting progression-free survival for chordoma patients with 95% confidence intervals (grey shading)

Fig. 3

Competing risk analysis for chordoma patients. The plot illustrates cumulative incidence functions for the competing events: progression and death with 95% confidence intervals (grey shading)

Fig. 4

Kaplan–Meier survival analysis depicting overall survival for chondrosarcoma patients with 95% confidence intervals (grey shading)

Fig. 5

Kaplan–Meier survival analysis depicting progression-free survival for chondrosarcoma patients with 95% confidence intervals (grey shading)

Fig. 6

Competing risk analysis for chondrosarcoma patients. The plot illustrates a cumulative incidence function for the progression with 95% confidence intervals (grey shading). There were no competing events observed during the follow-up period