• World Neurosurg · Jan 2018

    Presentation, treatment, and long-term outcome of intrasellar chordoma: a pooled analysis of institutional, SEER, and published data.

    • Abdul-Kareem Ahmed, Hassan Y Dawood, Omar M Arnaout, Edward R Laws, and Timothy R Smith.
    • Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: abdul-kareem_ahmed@brown.edu.
    • World Neurosurg. 2018 Jan 1; 109: e676-e683.

    BackgroundChordoma that occurs primarily in the sella turcica is rare and presents unique treatment challenges.ObjectiveThe purpose of this study was to determine common features, treatment approaches, and survival characteristics of intrasellar chordoma.MethodsInstitutional databases, the SEER (Surveillance Epidemiology and End Results) database, and PubMed/EMBASE were queried for chordoma with a primarily intrasellar component. The SEER database was also queried for adult skull base chordoma. Patient-level data were extracted where available. Kaplan-Meier survival analyses were conducted.ResultsAmong 80 cases, the mean age at presentation was 55.6 (standard deviation, 15.9), with a female predominance (1.16:1.00). Patients experienced symptoms for a mean duration of 19.0 months, including cranial nerve deficits, hypopituitarism, and hyperprolactinemia. Among patients receiving treatment, 77.5% underwent surgery. In addition, less than half of the patients (n = 34, 47.3%) received adjuvant radiation therapy. The 5-year overall survival (OS) of intrasellar chordoma was 60.0% (standard error [SE], 6.9). Patients aged 40 years and younger had a 5-year OS of 80.8% (SE, 12.2), compared with patients older than 40 years, who had an OS of 55.4% (SE, 7.7) (Mantel-Cox, P = 0.044). Males experienced a lower 5-year OS (44.0; SE, 9.7) than did females (76.8; SE, 8.5), (Mantel-Cox, P = 0.003). Median OS was greater in patients with skull base chordoma than in patients with intrasellar chordoma (Mantel-Cox, P = 0.046).ConclusionsIntrasellar chordoma presents frequently with visual disturbances and hyperprolactinemia and has a slightly higher incidence in females. Young age predicts a better prognosis. Intrasellar chordoma has a lower overall survival than has skull base chordoma.Copyright © 2017 Elsevier Inc. All rights reserved.

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