• Jin-Feng Huang, Dong Chen, Chang-Min Sang, Xuan-Qi Zheng, Jia-Liang Lin, Yan Lin, Wen-Fei Ni, Xiang-Yang Wang, Yan Michael Li, and Ai-Min Wu.
• Department of Spine Surgery, Zhejiang Spine Surgery Centre, Orthopaedic Hospital, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang, China.
• World Neurosurg. 2019 May 1.

BackgroundChordoma is a type of rare bone tumor and is a relatively slow-growing, low-grade malignancy that is locally invasive and aggressive. The nomogram is widely used in the field of cancer because it can provide a clear picture for clinicians to predict the survival rate, which can lead more accurate decisions in clinical treatment.MethodsOverall, 875 patients with a primary spinal chordoma were identified and collected from the Surveillance, Epidemiology, and End Results registry databases (1973-2015). The nomogram was established based on 425 patients with complete data. The predictive accuracy and discriminative ability of the nomogram were determined by the concordance index (C-index) and calibration curve.ResultsThe statistical nomogram was built on 10 independent prognostic factors: age, sex, race, disease stage, surgery, year of diagnosis, marital status, primary site, radiation, and tumor size, with C-indices of 0.76. The calibration curve to determine the probability of survival showed good agreement between the predictions by the nomogram and actual observation. Tumor diameter >10 cm (hazard ratio [HR] 2.95, 95% confidence interval [CI] 1.77-4.90, P < 0.001), regional invasive (HR 1.71, 95% CI 1.16-2.53, P < 0.01), and distant metastasis (HR 3.44, 95% CI 1.98-5.96, P< 0.001) were independent risk factors for poor survival. Undergoing subtotal resection or gross total resection (HR 0.37, 95% CI 0.25-0.56, P < 0.001; HR 0.26, 95% CI 0.17-0.41, respectively) and a primary site located in the sacrum/pelvis (HR 0.51, 95% CI 0.34-0.78, P < 0.01) were prognostic factors for better survival.ConclusionsThe nomogram provided more accurate prognostic predictions for patients with spinal chordoma. Moreover, our study suggests that tumor diameter >5 cm, distant metastasis, and not performing resection are major risk factors that can dramatically decrease the survival time of patients with spinal chordoma.Copyright © 2019 Elsevier Inc. All rights reserved.

5 keywords...

hide…