Proposal and Validation of a Basic Progression Scoring System for Patients with Skull Base Chordoma

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• 作者：Jun-Peng Ma¹ ; ⁴ ; ⁵ ; ⁶ ; Kai-Bing Tian¹ ; ⁴ ; ⁵ ; ⁶ ; Liang Wang¹ ; ⁴ ; ⁵ ; ⁶ ; Ke Wang¹ ; ⁴ ; ⁵ ; ⁶ ; Da Li¹ ; ⁴ ; ⁵ ; ⁶ ; Yang Yang¹ ; ⁴ ; ⁵ ; ⁶ ; Jiang Du² ; ⁷ ; ⁸ ; Xiao-Juan Ru³ ; Li-Wei Zhang¹ ; ⁴ ; ⁵ ; ⁶ ; Zhen Wu¹ ; ⁴ ; ⁵ ; ⁶ ; Jun-Ting Zhang¹ ; ⁴ ; ⁵ ; ⁶ ; ^{zhangjunting2003@aliyun.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Chordoma ; Prognosis ; Progression ; Scoring system ; Skull base
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：91
• 期：Complete
• 页码：409-418
• 全文大小：4812 K

文摘

To propose and further validate a basic progression scoring system for patients with skull base chordoma.

Methods

All patients (n = 170) undergoing operation for skull base chordoma were classified randomly into a training (n = 113) or validation set (n = 57). In the training set, adverse factors for progression were analyzed by univariate and multivariate analyses. Significant independent factors were included into the scoring system. Scores for each risk category were allocated 1 point and each protection category 0 point. Three prognostic groups were formed on the basis of total score. The same scoring and grouping dispositions were made in the validation set. Analyses of the differences among the 3 groups in individual sets with regard to recurrence and the comparisons between the corresponding prognostic groups of both sets were all carried out by the Kaplan-Meier method.

Results

In the training set, age, treatment history, preoperative Karnofsky performance scale, pathology, and features on magnetic resonance imaging were all significant independent factors and were included into the scoring system. According to the total score, 3 prognostic groups were formed, group A (0–1 points), group B (2–3 points), and group C (3–4 points), respectively. The pairwise comparisons between every 2 of 3 groups in the training set showed significance with P < 0.001, whereas in validation set, a log-rank test showed significance, P ≤ 0.001 (log-rank test). The comparisons between the corresponding prognostic groups of both sets did not show significance.

Conclusions

The basic progression scoring system for patients with skull base chordoma is valid and reproducible.