TY - JOUR
T1 - Peri-operative prognostic factors for primary skull base chordomas
T2 - results from a single-center cohort
AU - La Corte, Emanuele
AU - Broggi, Morgan
AU - Raggi, Alberto
AU - Schiavolin, Silvia
AU - Acerbi, Francesco
AU - Danesi, Giovanni
AU - Farinotti, Mariangela
AU - Felisati, Giovanni
AU - Maccari, Alberto
AU - Pollo, Bianca
AU - Saini, Marco
AU - Toppo, Claudia
AU - Valvo, Francesca
AU - Ghidoni, Riccardo
AU - Bruzzone, Maria Grazia
AU - DiMeco, Francesco
AU - Ferroli, Paolo
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Austria, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Skull base chordomas (SBC) are rare malignant tumors and few factors have been found to be reliable markers for clinical decision making and survival prognostication. The aim of the present work was to identify specific prognostic factors potentially useful for the management of SBC patients. Methods: A retrospective review of all the patients diagnosed and treated for SBC at the Fondazione IRCCS Istituto Neurologico “Carlo Besta” between January 1992 and December 2017 has been performed. Survival analysis was performed and a logistic regression model was used. Statistically significant predictors were rated based on their log odds in order to preliminarily build a personalized grading scale—the Peri-Operative Chordoma Scale (POCS). Results: Fifty-nine primary chordoma patients were included. The average follow-up from the first treatment was 82.6 months (95% CI, 65.5–99.7). POCS was built over PFS and MR contrast enhancement (intense vs mild/no, value 4), preoperative motor deficit (yes vs no, value 3), and the development of any postoperative complications (yes vs no, value 2). POCS ranges between 0 and 9, with higher scores being associated with reduced likelihood of survival and progression-free state. Conclusions: Our results show that preoperative clinical symptoms (motor deficits), surgical features (extent of tumor resection and surgeon’s experience), development of postoperative complications, and KPS decline represent significant prognostic factors. The degree of MR contrast enhancement significantly correlated to both OS and PFS. We also preliminarily developed the POCS as a prognostic grading scale which may help neurosurgeons in the personalized management of patients undergoing potential adjuvant therapies.
AB - Background: Skull base chordomas (SBC) are rare malignant tumors and few factors have been found to be reliable markers for clinical decision making and survival prognostication. The aim of the present work was to identify specific prognostic factors potentially useful for the management of SBC patients. Methods: A retrospective review of all the patients diagnosed and treated for SBC at the Fondazione IRCCS Istituto Neurologico “Carlo Besta” between January 1992 and December 2017 has been performed. Survival analysis was performed and a logistic regression model was used. Statistically significant predictors were rated based on their log odds in order to preliminarily build a personalized grading scale—the Peri-Operative Chordoma Scale (POCS). Results: Fifty-nine primary chordoma patients were included. The average follow-up from the first treatment was 82.6 months (95% CI, 65.5–99.7). POCS was built over PFS and MR contrast enhancement (intense vs mild/no, value 4), preoperative motor deficit (yes vs no, value 3), and the development of any postoperative complications (yes vs no, value 2). POCS ranges between 0 and 9, with higher scores being associated with reduced likelihood of survival and progression-free state. Conclusions: Our results show that preoperative clinical symptoms (motor deficits), surgical features (extent of tumor resection and surgeon’s experience), development of postoperative complications, and KPS decline represent significant prognostic factors. The degree of MR contrast enhancement significantly correlated to both OS and PFS. We also preliminarily developed the POCS as a prognostic grading scale which may help neurosurgeons in the personalized management of patients undergoing potential adjuvant therapies.
KW - Chordoma
KW - Clivus
KW - Complication
KW - Endoscopic endonasal approach
KW - Grading system
KW - Outcome
KW - Skull base
KW - Skull base surgery
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U2 - 10.1007/s00701-020-04219-7
DO - 10.1007/s00701-020-04219-7
M3 - Article
C2 - 31950268
AN - SCOPUS:85078029819
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
ER -