Park Hangeul, Choi Yunhee, Lee Sungjoon, Lee Sun-Ho, Kim Eun-Sang, Jang Sun Woo, Park Jin Hoon, Cho Yunseong, Jang Giwuk, Ha Yoon, Dho Yun-Sik, Yoo Heon, Lee Sung Uk, Seo Seung-Ho, Kim Ki-Jeong, Sohn Seil, Chung Chun Kee
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.
Neurospine. 2024 Sep;21(3):942-953. doi: 10.14245/ns.2448448.224. Epub 2024 Sep 30.
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04-1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
脊索瘤是一种起源于胚胎脊索残余的罕见恶性肿瘤，对传统治疗具有高度抗性，因此手术切除至关重要。然而，影响颈椎脊索瘤预后的具体因素尚未明确。我们在一项全国多中心回顾性研究中，对影响颈椎脊索瘤预后的因素进行调查。
本研究纳入了1998年1月至2023年3月期间在7家三级转诊中心被诊断为颈椎脊索瘤的所有患者，排除斜坡和延伸至颈椎的胸椎脊索瘤患者。通过随访磁共振成像确定局部复发（LR），即在完全切除的肿瘤中再次出现或残余肿瘤中生长。该研究评估了LR和总生存期，分析了影响LR和死亡的因素。
45例颈椎脊索瘤患者的平均年龄为46.4岁。在中位随访52个月期间，分别有21例（46.7%）和4例（8.9%）观察到LR和远处转移，16例患者（36%）被确认死亡。5年和10年累积LR率分别为51.3%和60%，而5年和10年生存率分别为82%和53%。年龄是影响死亡率的唯一显著因素（风险比，1.04；95%置信区间，1.04 - 1.07；p = 0.015）。值得注意的是，切除程度和辅助治疗对局部肿瘤控制和死亡率没有统计学上的显著影响。
本研究是韩国对颈椎脊索瘤进行的最大规模多中心回顾性分析，确定年龄是显著影响患者生存的唯一因素。
