Characteristics and overall survival in pediatric versus adult skull base chordoma: a population-based study

Abstract

Purpose Less than 5% of chordomas occur in pediatric patients. While many studies have explored the treatment and outcomes of skull base chordomas, few have focused on the differences between pediatric and adult populations. The aim of this study is to analyze the epidemiological variables and clinical outcomes between pediatric and adult skull base chordomas using a largesample, population-based cancer database. Methods The National Cancer Database was queried between 2004 and 2015 for skull base chordomas. We stratified patients as pediatric (<18 years) and adults (≥18 years). We compared several clinical covariates between the two groups. Results Our cohort consisted of 658 patients, 61 pediatric (9.3%), and 597 adults (90.7%). Pediatric patients were more likely to have larger tumor size (41.4 ± 15.7 mm versus 34.1 ± 15.8 mm, p < 0.01) and universally treated at academic facilities. There was no significant difference in overall survival. Conclusions Pediatric skull base chordomas are rare tumors that are managed with aggressive surgical resection, followed by radiation. While there may be difference between tumor presentation, outcomes between pediatric and adult patients are similar.

A comparison of endoscopic endonasal versus open approaches for skull base chordoma: a comprehensive National Cancer Database analysis

“…Demographic features identified in our analysis did not differ significantly from those of previous studies. [11][12][13][14][15] At first glance, the 10-year OS in our cohort (68.7%) appears to be an improvement as compared to previous studies serving as historical controls (32.5%-39.9%). 3,16,17 However, direct comparisons should be inter-preted with caution given that previous studies included both surgical and nonsurgical patients as opposed to our purely surgical cohort.…”

“…15 Conversely, a Surveillance, Epidemiology, and End Results (SEER) analysis comparing pediatric and adult skull base chordoma populations (61 and 597 patients, respectively) revealed that pediatric patients did not have a survival benefit, even those with larger tumor sizes. 14 Restricting our cohort to skull base chordoma patients who were managed operatively, as opposed to all patients regardless of management strategy, likely resulted in the discordance of our findings with those of prior studies.…”

Proteomics and phosphoproteomics of chordoma biopsies reveal alterations in multiple pathways and aberrant kinases activities

“…Due to the slow proliferation rate of chordomas and their adjacency to the spine, chordoma tumor size is directly related to patient survival rate (51). We regarded tumor size to be large if its maximal diameter was greater than 5.0 cm, and small if under 5.0 cm, and thereby noted four large (L, n=4) and five small (S, n=5) chordomas (Table 1).…”