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Peri-operative prognostic factors for primary skull base chordomas: results from a single-center cohort.

  • Original Article - Tumor - Other
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Abstract

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.

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Authors and Affiliations

  1. Molecular and Translational Medicine, Department of Health Sciences, University of Milan, Milan, Italy

    Emanuele La Corte & Riccardo Ghidoni

  2. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Emanuele La Corte, Morgan Broggi, Francesco Acerbi, Marco Saini, Francesco DiMeco & Paolo Ferroli

  3. Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Alberto Raggi, Silvia Schiavolin & Claudia Toppo

  4. Division of Ear, Nose, and Throat, and Skull Base Microsurgery, Ospedali Riuniti, Bergamo, Italy

    Giovanni Danesi

  5. Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Mariangela Farinotti

  6. Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy

    Giovanni Felisati & Alberto Maccari

  7. Neuropathology Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Bianca Pollo

  8. National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy

    Francesca Valvo

  9. Department of Health Sciences, Clinical Biochemistry and Mass Spectrometry Laboratory, University of Milan, Milan, Italy

    Riccardo Ghidoni

  10. Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Maria Grazia Bruzzone

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  1. Emanuele La Corte
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Corresponding author

Correspondence to Emanuele La Corte.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Fondazione IRCCS Istituto Neurologico “Carlo Besta” research committee (Ref. 2015-034) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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La Corte, E., Broggi, M., Raggi, A. et al. Peri-operative prognostic factors for primary skull base chordomas: results from a single-center cohort.. Acta Neurochir 163, 689–697 (2021). https://doi.org/10.1007/s00701-020-04219-7

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