Department of Neurosurgery, HELIOS-Klinikum Berlin-Buch, Berlin, Germany.
Department of Neurosurgery, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
Neurol India. 2021 Nov-Dec;69(6):1608-1612. doi: 10.4103/0028-3886.333474.
Skull base chordoma (SBC) is relatively rare and data on its clinical outcome after surgical resection and adjuvant radiotherapy are still limited.
Analyzing the clinical postoperative outcome of SBC patients and defining prognostic factors regarding current treatment modalities.
In this study, 41 SBC patients from 2001 to 2017 were retrospectively analyzed in this single-center study.
The most common clinical symptoms were headache (63%) and problems concerning vision (54%) like diplopia. The follow-up controls took place from 1 to 192 months. The mean survival time for the patients was 123.37 months (95% CI 90.89-155.86). The 5- and 10-year survival rates were 73.3 and 49%, respectively. Regarding the Karnofsky-Performance Scale (KPS), Cox regression showed a significant relationship between the survival rates in the overall study population and pre-surgery KPS (P = 0.004). This was further supported with a positive significant correlation between the pre-surgery KPS and the KPS at the last follow-up (P = 0.039).
Statistical analysis showed that repeat surgical resection and radiotherapy could be prognostic factors. Furthermore, we were able to show that mortality decreased by 4.5% with each 10 points increase of pre-surgery KPS. This could be a major prognostic factor when deciding treatment modalities. Nevertheless, further standardized clinical studies with a larger patient population should be carried out to extrapolate prognostic factors and improve treatment modalities.
颅底脊索瘤（SBC）较为罕见，目前关于其手术切除和辅助放疗后临床结果的数据仍然有限。
分析 SBC 患者的临床术后结果，并确定当前治疗方式的预后因素。
在这项单中心研究中，回顾性分析了 2001 年至 2017 年期间的 41 例 SBC 患者。
最常见的临床症状是头痛（63%）和与视觉相关的问题（54%），如复视。随访时间为 1 至 192 个月。患者的平均生存时间为 123.37 个月（95%CI 90.89-155.86）。5 年和 10 年生存率分别为 73.3%和 49%。根据 Karnofsky 表现量表（KPS），Cox 回归分析显示，总体研究人群的生存率与术前 KPS 之间存在显著关系（P=0.004）。这进一步得到了术前 KPS 与最后一次随访时 KPS 之间呈正相关关系的支持（P=0.039）。
统计分析表明，重复手术切除和放疗可能是预后因素。此外，我们还能够表明，术前 KPS 每增加 10 分，死亡率降低 4.5%。这可能是决定治疗方式时的一个主要预后因素。然而，应该进行进一步的标准化临床研究，以增加患者数量，推断预后因素并改善治疗方式。
