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Effect comparisons among treatment measures on progression-free survival in patients with skull base chordomas: a retrospective study of 234 post-surgical cases

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

Skull base chordoma (SBC) is a rare and refractory tumor with a high rate of relapse. We aimed to investigate the relationships between different treatment measures and progression-free survival (PFS) outcomes.

Methods

Data from 234 SBC patients from one institution were retrieved from a prospectively maintained database. After grouping, the clinicopathological features and mean estimated PFS times were subject to inter-group and intra-group comparisons, and prognostic factors of PFS were estimated by statistical analyses. Two typical primary patients who suffered from repeated tumor relapses are described.

Results

In addition to pathological subtype (p = 0.005), the initial treatment measure for the primary cases (n = 180) was identified as an independent factor of tumor progression (p = 0.002). The patients with gross total resection exhibited the best mean estimated PFS time (109.5 months). Patients with intralesional resection exhibited the shortest PFS time (38.3 months), with an almost significant difference (p = 0.058) compared to those with adjuvant radiotherapy following intralesional resection (56.6 months). For the recurrent group (n = 54), marginal resection (p = 0.007) and adjuvant radiotherapy (p = 0.041) were confirmed as independent protective factors for PFS. The longest mean PFS time (60.3 months) was noted in those patients who received marginal resection followed by adjuvant radiotherapy.

Conclusions

Treatment measures were crucial for post-surgical tumor progression in both primary and recurrent cases. For primary cases, gross total resection and adjuvant radiotherapy offered more PFS benefits to all patients and those who underwent intralesional resection. Marginal resection and adjuvant radiotherapy, which are proposed as a general treatment paradigm for primary tumors, were also equally effective when applied to relapsing tumors.

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Acknowledgements

We are grateful to all colleagues who participated in providing cases (Dr. Wang Jia, Dr. Xinru Xiao, Dr. Guolu Meng, and Dr. Jie Tang) and data collection (Dr. Da Li).

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng Distract, Beijing, People’s Republic of China, 100050

    Liang Wang, Kaibing Tian, Junpeng Ma, Ke Wang, Guijun Jia, Zhen Wu, Liwei Zhang & Junting Zhang

  2. China National Clinical Research Center for Neurological Diseases, Tiantan Xili 6, Dongcheng Distract, Beijing, People’s Republic of China, 100050

    Liang Wang, Ke Wang, Guijun Jia, Zhen Wu, Liwei Zhang & Junting Zhang

Authors
  1. Liang Wang
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  2. Kaibing Tian
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  3. Junpeng Ma
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  4. Ke Wang
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  5. Guijun Jia
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  6. Zhen Wu
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  7. Liwei Zhang
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  8. Junting Zhang
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Corresponding author

Correspondence to Junting Zhang.

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Funding

The National Natural Science Foundation of China (Grant Nos. 81472370; 81541146) and the Beijing Municipal Natural Science Foundation (Grant Nos. 7142052; 7163212) provided financial support for this study.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licencing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Formal consent was not required for this type of study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Wang, L., Tian, K., Ma, J. et al. Effect comparisons among treatment measures on progression-free survival in patients with skull base chordomas: a retrospective study of 234 post-surgical cases. Acta Neurochir 159, 1803–1813 (2017). https://doi.org/10.1007/s00701-017-3261-6

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  • DOI: https://doi.org/10.1007/s00701-017-3261-6

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