机构：[1]Departments of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China[2]Departments of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China[3]Hunan University of Chinese Medicine, Changsha, Hunan, China[4]Departments of Radiology,Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA[5]Departments of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA[6]Departments of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China[7]Departments of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China[8]Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome Sapienza, Rome, Italy[9]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[10]Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
OBJECTIVE: To investigate prognostic factors of clival chordoma using the largest patient set to date. METHODS: Appropriate studies were identified per search criteria, data satisfying criteria were extracted, and survival analysis was performed to investigate prognostic factors of clival chordoma. RESULTS: A total of 347 patients from the literature cohort met our inclusion criteria. Of 346 cases in which extent of resection was reported, gross total resection (GTR), subtotal resection, and biopsy were achieved in 118 (34.1%), 205 (59.2%), and 21 (6.1%) cases, respectively. Two (0.6%) subjects did not undergo surgery. Of 185 cases in which surgical approach was reported, 56 (30.3%) underwent an endoscopic transoral approach, 17 (9.2%) microscopic transsphenoidal, 45 (24.3%) endoscopic or microscopic, 45 (24.3%) craniotomy, and 22 (11.9%) other approaches. There was no significant difference in GTR rates of different surgical approaches (P = 0.101). Median follow-up was 46.6 months. The 5- and 10-year rates for progression-free survival (PFS) were 59.2% and 47.9%, respectively. The 5- and 10-year rates for overall survival (OS) were 77.3% and 63.9%, respectively. On multivariate analysis for both PFS and OS, GTR demonstrated significantly improved outcomes when compared with subtotal resection (hazard ratio 0.45, 95% confidence interval 0.22-0.90, P = 0.025 for PFS; hazard ratio 0.20, confidence interval 0.06-0.65, P = 0.008 for OS). CONCLUSIONS: GTR rates were comparable in different surgical approaches. GTR was a significant predictor of longer PFS and OS in clival chordoma.
基金：
Shenghua Yuying Project of Central South University; Natural Science Foundation of Hunan Province, ChinaNatural Science Foundation of Hunan Province [2018JJ3709]; Natural Science Foundation of ChinaNational Natural Science Foundation of China [81472594, 81770781]
第一作者机构：[1]Departments of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China[3]Hunan University of Chinese Medicine, Changsha, Hunan, China[6]Departments of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
共同第一作者：
通讯作者：
通讯机构：[1]Departments of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
推荐引用方式(GB/T 7714)：
Zou Yingjie,Neale Natalie,Sun James,et al.Prognostic Factors in Clival Chordomas: An Integrated Analysis of 347 Patients[J].WORLD NEUROSURGERY.2018,118:E375-E387.doi:10.1016/j.wneu.2018.06.194.
APA：
Zou, Yingjie,Neale, Natalie,Sun, James,Yang, Mo,Bai, Harrison Xiao...&Yang, Li.(2018).Prognostic Factors in Clival Chordomas: An Integrated Analysis of 347 Patients.WORLD NEUROSURGERY,118,
MLA：
Zou, Yingjie,et al."Prognostic Factors in Clival Chordomas: An Integrated Analysis of 347 Patients".WORLD NEUROSURGERY 118.(2018):E375-E387
