Prognostic Factors and Survival Outcomes in Patients with Chordoma in the United States: A Population-Based Analysis.

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Prognostic Factors and Survival Outcomes in Patients with Chordoma in the United States: A Population-Based Analysis.

World Neurosurg. 2017 Apr 27;:

Authors: Lee IJ, Lee RJ, Fahim DK

Abstract
OBJECTIVE: To evaluate prognostic factors of patients with chordoma through a population-based analysis.
METHODS: 1598 patients in the Surveillance, Epidemiology, and End Results (SEER) database, diagnosed with chordoma from 1973-2013 were reviewed. Kaplan-Meier univariate analysis and Cox Regression multivariate analysis were performed to examine prognostic factors in overall survival (OS) and disease-specific survival (DSS).
RESULTS: Kaplan-Meier analysis showed an OS and DSS were 61% and 71% at 5 years, 41% and 57% at 10 years. Multivariate Cox regression analysis demonstrated that independent predictors of OS and DSS to be age at diagnosis (HR = 2.80 [95% CI, 2.12-3.70], P < .001; HR = 1.60 [95%CI, 1.18-2.16], P = .002), surgical treatment (HR = 0.62 [95% CI, 0.52-0.73], P < .001; HR = 0.64 [95%CI, 0.52-0.79], P < .001), radiation therapy (HR = 1.23 [95% CI, 1.07-1.42], P = .004; HR = 1.29 [95%CI, 1.09-1.54], P = .004), tumor size (HR = 1.53 [95% CI, 1.32-1.78], P < .001; HR = 1.62 [95%CI, 1.35-1.94], P < .001) and distant metastasis (HR = 3.40 [95% CI, 2.45-4.71], P < .001; HR = 3.77 [95%CI, 2.61-5.45], P < .001).
CONCLUSION: We report the largest study to date to evaluate prognostic factors of patients with chordoma. Multivariate analysis demonstrated that older age, greater tumor size and distant metastasis were correlated with decreased survival, whereas surgical resection was correlated with increased survival. Patients receiving radiation therapy also showed decreased survival, likely an indication of the patients' advanced stage of disease, making them poor surgical candidates.

PMID: 28457925 [PubMed - as supplied by publisher]

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