Neurospine.
2024 Sep;21(3):942-953. 10.14245/ns.2448448.224.
The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
- Park H
1 - Choi Y2
- Lee S3
- Lee SH3
- Kim ES3
- Jang SW4
- Park JH4
- Cho Y5
- Jang G5
- Ha Y5
- Dho YS6
- Yoo H6
- Lee SU7
- Seo SH8
- Kim KJ8
- Sohn S9
- Chung CK10
- Affiliations
-
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- 2Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
- 3Department of Neurosurgery, Samsung Medical Center, Seoul, Korea
- 4Department of Neurosurgery, Asan Medical Center, Seoul, Korea
- 5Department of Neurosurgery, Severance Hospital, Seoul, Korea
- 6Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea
- 7Center for Proton Therapy, National Cancer Center, Goyang, Korea
- 8Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- 9Department of Neurosurgery, CHA Bundang Medical Center, Seongnam, Korea
- 10Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2560327
- DOI: http://doi.org/10.14245/ns.2448448.224
Abstract
Objective
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
