Analysis of Clinical Features and Outcomes of Skull Base Chordoma in Different Age-Groups

World Neurosurg. 2016 Aug:92:407-417. doi: 10.1016/j.wneu.2016.05.035. Epub 2016 May 27.

Abstract

Objective: The objective of the current study was to compare the clinical features and outcomes between younger and older patients with skull base chordoma (SBC).

Methods: In this retrospective study, patients with SBC who underwent surgical treatment between February 2005 and December 2014 were included. Clinical features were recorded, including the signal intensity ratio of tumor to brain stem in T1 (RT1), T2 (RT2), and enhanced T1 (REN) sequences in primary patients with complete preoperative magnetic resonance images. The clinical features and outcomes were compared between younger (≤24 years) and older patients (≥25 years).

Results: In the present study, 238 patients were included. Younger patients experience more aggressive resection than do older patients (P = 0.045), and the SBCs of younger patients tended to be located in the occipitocervical region compared with older patients (P = 0.007). REN value in the younger group was lower than in the older group (P = 0.014), and the value of RT2 was higher in younger patients than in older patients (P = 0.015). The risk of progression was higher in older patients compared with younger patients (P = 0.030); the risk of having a poor neurologic status in older patients was higher than in younger patients (P = 0.044).

Conclusions: In younger patients, there were more SBCs located in the occipitocervical regions, and younger patients tended to undergo more aggressive resection. The tumor signal intensity of younger patients with SBC was higher in T2 images but lower in enhanced T1 images. A younger age was a favorable factor for a longer progression-free survival and a good neurologic status at follow-up.

Keywords: Age; Clinical feature; Outcome; Skull base chordoma.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aging*
  • Child
  • Child, Preschool
  • Chordoma / diagnostic imaging
  • Chordoma / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Karnofsky Performance Status
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / surgery*
  • Treatment Outcome*
  • Young Adult