Prognostic Factors in Patients With Spinal Chordoma: An Integrative Analysis of 682 Patients

Zhou, Jianhua; Sun, James; Bai, Harrison X.; Huang, Xiangyan; Zou, Ying-Ning; Tan, Xiao; Zhang, Zishu; Tang, Xiangqi; Tao, Yongguang; Xiao, Bo; Zhang, Paul J.; Yang, Li

doi:10.1093/neuros/nyx081

Cited by 51 publications

(43 citation statements)

References 33 publications

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“…In addition, the extent of the initial surgical resection is also prognostically significant. It was previously reported that age, sex, treatment history, tumor location, pathological grade, surgical margin, radiotherapy and chemotherapy affect the long-term prognosis of chordoma patients (37). In the same cohort, younger age (pediatric group), sacral location, dedifferentiated tumors and chemotherapy were identified as independent risk factors of shorter progression-free survival, whereas larger tumor size and tumor necrosis have also been implicated as negative prognostic factors (7).…”

Section: Discussionmentioning

confidence: 75%

Sacral and thoracic chordoma with pulmonary metastases: A case report and review of the literature

et al. 2020

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Chordoma is a sporadic type of cancer that affects the spine and is particularly challenging to treat due to the paucity of reported cases and scientific literature. In particular, primary chordomas affecting both the sacral and thoracic vertebrae are extremely rare. We herein report a rare case of chordoma in the sacral and thoracic vertebrae with pulmonary metastasis, along with a literature review. The objective of the present study was to explore treatment options and long-term outcomes in patients with metastatic chordoma. Posterior decompression was performed for the thoracic tumor, followed by extended resection of the sacral tumor. The symptoms of the patient were relieved after surgery, and the postoperative Nurick score decreased from grade 3 to grade 2, while the postoperative McCormick score was I. Therefore, complete chordoma excision and internal spinal fixation may effectively reduce tumor recurrence and metastasis.

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Section: Discussionmentioning

confidence: 75%

Sacral and thoracic chordoma with pulmonary metastases: A case report and review of the literature

et al. 2020

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“…21 A few prior database studies have examined incidence, prognostic factors, and treatment, but data directly comparing survival outcomes of radiotherapy, chemotherapy, and extent of surgical management is scarce. 1,2,22,23 Previous studies have identified several prognostic factors and in patients with spinal chordomas based on sociodemographic and treatment characteristics. These include factors such as age, type of treatment center, tumor size, metastasis, and treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

“…25 Although chordomas are more resistant to radiotherapy, radiotherapy may provide benefit in patients with spinal chordoma, especially in patients with a positive surgical margin. 2,3,19 Yang et al conducted an integrated analysis of 523 patients to determine the efficacy of radiotherapy, reported as 5-year overall survival. For patients with a positive surgical margin, overall survival was higher (69.1%) for patients who received radiotherapy compared to no radiotherapy (39.4%, P ¼ 0.021).…”

Section: Discussionmentioning

confidence: 99%

Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States

Patel

Nunna

Nie

et al. 2021

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgical resection with questionable efficacy of adjuvant therapies such as radiation and chemotherapy. Here we provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chordoma. Methods: Patients with diagnosis codes specific for chordoma of spine, sacrum, and coccyx were queried from the National Cancer Database (NCDB) during the years 2004-2016. Outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization. Results: 1,548 individuals were identified with a diagnosis of chordoma, 60.9% of which were at the sacrum or coccyx and 39.1% at the spine. The mean overall survival of patients in our cohort was 8.2 years. Increased age, larger tumor size, and presence of metastases were associated with worsened overall survival. 71.2% of patients received surgical intervention and both partial and radical resection were associated with significantly improved overall survival ( P < 0.001). Neither radiotherapy nor chemotherapy administration improved overall survival; however, amongst patients who received radiation, those who received proton-based radiation had significantly improved overall survival compared to traditional radiation. Conclusion: Surgical resection significantly improves overall survival in patients with spinal chordoma. In those patients receiving radiation, those who receive proton-based modalities have improved overall survival. Further studies into proton radiotherapy doses are required.

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“…In the two patient cohorts, the Kaplan-Meier curve by univariate log-rank test was used to compare difference in survival probabilities between different subgroups. Similarly, multivariate Cox regression analysis was also performed on these data sets to see whether the miRscore model could independently predict patient survival, after controlling for other clinical predictors that were previously reported in literature (32)(33)(34) and/or significant in our univariate survival analysis. Time-dependent receiver operating characteristic (ROC) curve was used in both cohorts to evaluate the sensitivity and specificity of variables for survival prediction.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a 6-miRNA Prognostic Signature in Spinal Chordoma

et al. 2020

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Prognostic Factors in Patients With Spinal Chordoma: An Integrative Analysis of 682 Patients

Cited by 51 publications

References 33 publications

Sacral and thoracic chordoma with pulmonary metastases: A case report and review of the literature

Sacral and thoracic chordoma with pulmonary metastases: A case report and review of the literature

Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States

Development and Validation of a 6-miRNA Prognostic Signature in Spinal Chordoma

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