BACKGROUND Skull base chordomas (SBC) are rare malignant tumors and few factors have been found to be reliable markers for clinical decision making and survival prognostication. The aim of the present work was to identify specific prognostic factors potentially useful for the management of SBC patients. METHODS A retrospective review of all the patients diagnosed and treated for SBC at the Fondazione IRCCS Istituto Neurologico "Carlo Besta" between January 1992 and December 2017 has been performed. Survival analysis was performed and a logistic regression model was used. Statistically significant predictors were rated based on their log odds in order to preliminarily build a personalized grading scale-the Peri-Operative Chordoma Scale (POCS). RESULTS Fifty-nine primary chordoma patients were included. The average follow-up from the first treatment was 82.6 months (95% CI, 65.5-99.7). POCS was built over PFS and MR contrast enhancement (intense vs mild/no, value 4), preoperative motor deficit (yes vs no, value 3), and the development of any postoperative complications (yes vs no, value 2). POCS ranges between 0 and 9, with higher scores being associated with reduced likelihood of survival and progression-free state. CONCLUSIONS Our results show that preoperative clinical symptoms (motor deficits), surgical features (extent of tumor resection and surgeon's experience), development of postoperative complications, and KPS decline represent significant prognostic factors. The degree of MR contrast enhancement significantly correlated to both OS and PFS. We also preliminarily developed the POCS as a prognostic grading scale which may help neurosurgeons in the personalized management of patients undergoing potential adjuvant therapies.

中文翻译：

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原发性颅底脊索瘤的围手术期预后因素：来自单中心队列的结果。

背景技术颅底脊索瘤（SBC）是罕见的恶性肿瘤，很少发现因素是临床决策和生存预后的可靠标志。本研究的目的是确定可能对SBC患者的治疗有用的特定预后因素。方法对1992年1月至2017年12月在Fondazione IRCCS Istituto Neurologico“ Carlo Besta”诊断和治疗过SBC的所有患者进行回顾性研究。进行生存分析，并使用逻辑回归模型。根据统计对数预测值的对数比对它们进行评分，以初步建立个性化的分级量表-围手术期脊索瘤量表（POCS）。结果纳入59例原发性脊索瘤患者。首次治疗的平均随访时间为82.6个月（95％CI，65.5-99.7）。POCS建立在PFS和MR对比增强（强度vs轻度/否，值4），术前运动功能障碍（是vs否，值3）和术后并发症的发展（是vs否，值2）的基础上。POCS的范围在0到9之间，得分越高，存活率和无进展状态的可能性越低。结论我们的结果表明，术前临床症状（运动缺陷），手术特征（肿瘤切除的程度和外科医生的经验），术后并发症的发生以及KPS下降是重要的预后因素。MR对比增强的程度与OS和PFS均显着相关。