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Characteristics and overall survival in pediatric versus adult skull base chordoma: a population-based study
Jordan C Xu1, Brandon M Lehrich2, Tyler M Yasaka3
1Department of Neurosurgery, University of California, Irvine, CA, USA.
Insights
Pediatric skull base chordomas are rare, often presenting with larger tumors. However, outcomes are similar to adult skull base chordomas, despite differences in presentation and treatment facility.
Area of Science:
- Oncology
- Pediatric Oncology
- Neurosurgery
Background:
- Chordomas are rare bone tumors, with less than 5% occurring in pediatric patients.
- Skull base chordomas, while extensively studied in adults, lack comparative analysis with pediatric cases.
Purpose of the Study:
- To analyze epidemiological variables and clinical outcomes of pediatric versus adult skull base chordomas.
- To identify differences in tumor presentation and treatment between pediatric and adult populations.
Main Methods:
- Utilized the National Cancer Database (2004-2015) for skull base chordoma cases.
- Stratified patients into pediatric (<18 years) and adult (≥18 years) groups.
- Compared clinical covariates including tumor size and treatment facility.
Main Results:
- The cohort included 658 patients: 61 pediatric (9.3%) and 597 adults (90.7%).
- Pediatric patients had significantly larger tumors (41.4 mm vs. 34.1 mm, p < 0.01) and were treated at academic facilities.
- No significant difference in overall survival was observed between pediatric and adult groups.
Conclusions:
- Pediatric skull base chordomas are rare and typically managed with aggressive resection and radiation.
- Despite differences in tumor presentation and treatment settings, outcomes (overall survival) are similar for pediatric and adult patients.
Purpose:
Less than 5% of chordomas occur in pediatric patients. While many studies have explored the treatment and outcomes of skull base chordomas, few have focused on the differences between pediatric and adult populations. The aim of this study is to analyze the epidemiological variables and clinical outcomes between pediatric and adult skull base chordomas using a large-sample, population-based cancer database.
Methods:
The National Cancer Database was queried between 2004 and 2015 for skull base chordomas. We stratified patients as pediatric (<18 years) and adults (≥18 years). We compared several clinical covariates between the two groups.
Results:
Our cohort consisted of 658 patients, 61 pediatric (9.3%), and 597 adults (90.7%). Pediatric patients were more likely to have larger tumor size (41.4 ± 15.7 mm versus 34.1 ± 15.8 mm, p < 0.01) and universally treated at academic facilities. There was no significant difference in overall survival.
Conclusions:
Pediatric skull base chordomas are rare tumors that are managed with aggressive surgical resection, followed by radiation. While there may be difference between tumor presentation, outcomes between pediatric and adult patients are similar.
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