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Chordoma: demographics and survival analysis with a focus on racial disparities and the role of surgery, a U.S. population-based study

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Abstract

Background

Chordoma is a rare malignant tumor of notochordal origin that may appear anywhere in the axial skeleton from the skull base to the sacrum. This study presents findings from a large database query to highlight the demographic, clinical, and pathological factors, prognosis, and survival of chordomas.

Methods

The Surveillance, Epidemiology, and End Results (SEER) data based was used to identify patients with a “chordoma” diagnosis from 200 to 2018.

Results

In a total of 1600 cases, the mean age at diagnosis was 54.47 years (standard deviation, SD ± 19.62 years). Most cases were male (57.1%) and white (84.5%). Tumor size was found to be > 4 cm in 26% of cases. Histologically, 33% with known features had well-differentiated Grade I tumors, and 50.2% of the tumors were localized. Metastasis at the time of to the bone, liver, and lung was observed at a rate of 0.5%, 0.1%, and 0.7%, respectively. The most common treatment received was surgical resection (41.3%). The overall 5-year overall survival observed was 39% (confidence interval, CI 95% 37–41; p = 0.05) with patients who received surgery having a 5-year survival rate of 43% (CI 95% 40–46; p = 0.05). Multivariate analysis showed independent factors that contributed to worse prognosis chemotherapy only as a treatment modality and no surgery as a treatment modality.

Conclusion

Chordomas are more common in white males and appear between the 5th and 6th decades of life. Factors that contributed to a worse prognosis were Asian, Pacific Islander, American Indian, or Alaska Native races.

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Data Availability

All data is publicly available deidentified data from SEER database.

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Authors and Affiliations

  1. Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA

    Asad Ullah

  2. Medical College of Georgia, Augusta, GA, 30912, USA

    Guirshney Samarah Kenol & Kue Tylor Lee

  3. Department of Medicine, Bolan Medical College, Quetta, 83700, Pakistan

    Abdul Qahar Khan Yasinzai & Imran Khan

  4. Department of Surgery, San Joaquin General Hospital, French Camp, CA, 95231, USA

    Abdul Waheed

  5. Bannu Medical College, Bannu, 28100, Pakistan

    Bina Asif

  6. Frontier Medical and Dental College, Abbottabad, Pakistan

    Hajra Sharif

  7. Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    Jaffar Khan

  8. Department of Pathology, Cedars Sinai Medical Center, Los Angeles, CA, 90048, USA

    Saleh Heneidi

  9. Mitchell Cancer Institute, University of South Alabama, Mobile, AL, 36604, USA

    Nabin R. Karki

  10. Department of Neurology, Wake Forest Atrium Health, Charlotte, NC, 28203, USA

    Tamour Khan Tareen

  11. Department of Pathology and Laboratory Medicine, Vanderbilt University, Nashville, TN, 37232, USA

    Asad Ullah

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Contributions

All authors listed contributed to this manuscript from conceptualization, literature search, writing—original draft preparation, writing—review and editing. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Asad Ullah.

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Patient consent was waived due to this article being from the SEER database, which contains publicly available deidentified patients’ data from the National Cancer Institute (NCI), USA.

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Ullah, A., Kenol, G.S., Lee, K.T. et al. Chordoma: demographics and survival analysis with a focus on racial disparities and the role of surgery, a U.S. population-based study. Clin Transl Oncol 26, 109–118 (2024). https://doi.org/10.1007/s12094-023-03227-0

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