Chordomas are most frequently found in the sacrum, vertebral column, and skull base. Achieving gross-total resection (GTR) has been shown to optimize overall survival (OS); however, the efficacy of radiotherapy (RT) for patients with GTR is currently not well understood. Given that RT may negatively impact patient quality of life, the aim of this study was to evaluate the utility of RT for improving OS in patients who have undergone GTR of spinal chordoma through analysis of the national Surveillance, Epidemiology, and End Results (SEER) database.
开云体育世界杯赔率
The SEER database (1975–2018) was queried for all adult patients (≥ 21 years) who underwent GTR for spinal chordoma. Bivariate analysis was conducted using chi-square testing for categorical variables, and the log-rank test was performed to find the associations of clinical variables with OS. Cox proportional hazards models were generated for multivariate analyses of the associations among clinical variables and OS.
RESULTS
总啊,f 263 spinal chordomas that underwent GTR were identified. The mean age of all included patients was 58.72 years, and 63.9% of patients were male. In addition, 0.4% had dedifferentiated histology. The mean follow-up was 75.54 months. Of all patients, 152 (57.8%) received no RT and 111 (42.2%) received RT. Patients with sacral tumor location (80.9% vs 51.4%, p < 0.001) were more likely not to undergo RT when compared to patients with vertebral column location. In multivariate analysis, only age ≥ 65 years was associated with poorer OS (HR 3.16, CI 1.54–5.61, p < 0.001). RT did not have a statistically significant association with OS.
CONCLUSIONS
RT GTR的脊索瘤后没有改善操作系统中SEER chordoma patients to a value that achieved statistical significance. Additional multicenter prospective studies are needed to determine the true efficacy of RT after GTR of spinal chordoma.
CorrespondenceDebraj Mukherjee: Johns Hopkins University School of Medicine, Baltimore, MD.dmukher1@jhmi.edu.
INCLUDE WHEN CITINGPublished online June 9, 2023; DOI: 10.3171/2023.5.SPINE2396.
DisclosuresDr. Lubelski reported personal fees from Icotec and Mindset Medical outside the submitted work. Dr. Redmond reported travel expenses from Elekta AB and Brainlab; membership on the data safety monitoring board of BioMimetix; grants from Canon and Accuray; and consulting fees from Icotec outside the submitted work. Dr. Bettegowda reported consultant fees from DePuy-Synthes, Bionaut Labs, Haystack Oncology, Privo Technologies, and Galectin Therapeutics; and is the co-founder of OrisDx and Belay Diagnostics outside the submitted work.
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