The Analysis Of The Clinical Feature And The Prognostic Factors Of The Skull Base Chordomas

ObjectiveTo investigate the clinical and prognostic features of the skull base chordomas. Methods106 patients of skull base chordomas presented during May 1993 and June 2005 and treated by operations were undertaken follow-up by means of telephone or letters. The corresponding database was set up by the software of Epidata3.02. They were scored by Karnofsky Performance Scale (KPS) respectively during admission, before discharge and following-up. SPSS Life-table method were used to calculate the rates of recurrence and survival. 13 factors were analysed by the methods of Kaplan-Meier, Cox regression, and t-test, which including gender, age, chief symptoms, positive signs, bulk of the tumors, whether having received operations or radiotherapys, grouping and staging of the tumors'location, texture, adherence, pathological and resection groupings of the lesions.Results79 patients were flupped, and follow-up was 10-158 months, on the average of 63.9 months. 1, 3, 5 and 10 year survival rates were 87.2%, 79.4%, 67.6%and 59.5%. 1, 3, 5 and 10 year recurrent rates were19.1%, 34.7%, 52.9% and 88.3%. The mean KPS on admission, before discharge and following-up were 70.8, 72.4 and 85.7 respectively, and there was statistics significance between the latter and the other two. Results of the Kaplan-Meier single factor analysis displayed that factors including whether having received operations or radiotherapys, adherence, pathological and resection groupings of the lesions were the risk fators on the patients'life span.Meanwhile, Cox multiple factor analysis showed above factors except adherencegroupings of the lesions had statistical significance on the patients'life span.ConclusionsThe prognosis of the skull base chordomas was poor. The recurrent rate was ascending year by year, meanwhile the survival rate was descending during the first 7 years after the operation. Operations can improve patients'long-term qualityes of life, so they should be viewed as the first choice of the treatment. Whether having received operations or radiotherapys and the pathological and resection groupings of the lesions are the most important prognostic index of the disease. The prognosis of the skull base chordomas would be better by making more reasonable arrange of the combined therapy and making better use of therapeutic methods such as surgical technique.