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Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgi...

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Autores principales: Patel, Saavan, Nunna, Ravi S., Nie, James, Ansari, Darius, Chaudhry, Nauman S., Mehta, Ankit I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972264/
https://www.ncbi.nlm.nih.gov/pubmed/33583227
http://dx.doi.org/10.1177/2192568221995155
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author Patel, Saavan
Nunna, Ravi S.
Nie, James
Ansari, Darius
Chaudhry, Nauman S.
Mehta, Ankit I.
author_facet Patel, Saavan
Nunna, Ravi S.
Nie, James
Ansari, Darius
Chaudhry, Nauman S.
Mehta, Ankit I.
author_sort Patel, Saavan
collection PubMed
description STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgical resection with questionable efficacy of adjuvant therapies such as radiation and chemotherapy. Here we provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chordoma. METHODS: Patients with diagnosis codes specific for chordoma of spine, sacrum, and coccyx were queried from the National Cancer Database (NCDB) during the years 2004-2016. Outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization. RESULTS: 1,548 individuals were identified with a diagnosis of chordoma, 60.9% of which were at the sacrum or coccyx and 39.1% at the spine. The mean overall survival of patients in our cohort was 8.2 years. Increased age, larger tumor size, and presence of metastases were associated with worsened overall survival. 71.2% of patients received surgical intervention and both partial and radical resection were associated with significantly improved overall survival (P < 0.001). Neither radiotherapy nor chemotherapy administration improved overall survival; however, amongst patients who received radiation, those who received proton-based radiation had significantly improved overall survival compared to traditional radiation. CONCLUSION: Surgical resection significantly improves overall survival in patients with spinal chordoma. In those patients receiving radiation, those who receive proton-based modalities have improved overall survival. Further studies into proton radiotherapy doses are required.
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spelling pubmed-99722642023-03-01 Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States Patel, Saavan Nunna, Ravi S. Nie, James Ansari, Darius Chaudhry, Nauman S. Mehta, Ankit I. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgical resection with questionable efficacy of adjuvant therapies such as radiation and chemotherapy. Here we provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chordoma. METHODS: Patients with diagnosis codes specific for chordoma of spine, sacrum, and coccyx were queried from the National Cancer Database (NCDB) during the years 2004-2016. Outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization. RESULTS: 1,548 individuals were identified with a diagnosis of chordoma, 60.9% of which were at the sacrum or coccyx and 39.1% at the spine. The mean overall survival of patients in our cohort was 8.2 years. Increased age, larger tumor size, and presence of metastases were associated with worsened overall survival. 71.2% of patients received surgical intervention and both partial and radical resection were associated with significantly improved overall survival (P < 0.001). Neither radiotherapy nor chemotherapy administration improved overall survival; however, amongst patients who received radiation, those who received proton-based radiation had significantly improved overall survival compared to traditional radiation. CONCLUSION: Surgical resection significantly improves overall survival in patients with spinal chordoma. In those patients receiving radiation, those who receive proton-based modalities have improved overall survival. Further studies into proton radiotherapy doses are required. SAGE Publications 2021-02-15 2023-03 /pmc/articles/PMC9972264/ /pubmed/33583227 http://dx.doi.org/10.1177/2192568221995155 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Patel, Saavan
Nunna, Ravi S.
Nie, James
Ansari, Darius
Chaudhry, Nauman S.
Mehta, Ankit I.
Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title_full Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title_fullStr Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title_full_unstemmed Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title_short Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
title_sort incidence, management, and outcomes of adult spinal chordoma patients in the united states
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972264/
https://www.ncbi.nlm.nih.gov/pubmed/33583227
http://dx.doi.org/10.1177/2192568221995155
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