脊柱脊索瘤是原发性骨肿瘤，手术仍然是主要治疗方法。然而，其发病率低、缺乏证据以及疾病表现较晚，使得管理具有挑战性。在这里，我们报告了一大群患者手术切除后的术后结果，研究了总生存期 (OS) 和局部无复发生存期 (LRFS) 时间的预测因素，以及多个时间段内功能结果的趋势。所有患者的回顾性审查2003 年至 2023 年在第四级脊柱肿瘤中心对脊柱脊索瘤进行的随访也包括在内。收集有关人口统计学、术前和围手术期管理以及初次确定性手术后随访的数据。主要结局是 OS 和 LRFS，次要结局是功能缺陷。101 名患者的平均随访时间为 6.0 ± 4.2 年。截至人口普查时，25/101 (24.8%) 的患者复发，10/101 (9.9%) 的患者死亡。手术后，随着时间的推移，患者的疼痛明显减轻，但感觉缺陷、虚弱和肠/膀胱功能障碍的发生率保持不变。肿瘤≥100 cm3（风险比（HR）= 5.89，95% CI 1.72-20.18，P = .005）和活动脊柱脊索瘤（HR = 7.73，95% CI 2.09-28.59，P = .002）与更差的情况相关LRFS，而新辅助放疗与 LRFS 改善相关（HR = 0.09，95% CI 0.01-0.88，P = 0.038）。另一方面，年龄≥65岁与OS降低相关（HR = 16.70，95% CI 1.54-181.28，P = .021）。外科医生必须经常权衡整块切除和牺牲重要但受影响的部分的利弊天然组织。我们的研究结果可以为脊柱脊索瘤患者的咨询提供基准。肿瘤≥100 cm3的复发风险似乎高出5.89倍，活动性脊柱脊索瘤的风险高出7.73倍，新辅助放疗使局部复发的风险降低11.1倍。手术时年龄≥65 岁的患者的死亡风险比 <65 岁的患者高 16.70 倍。版权所有 © 神经外科医生大会 2024。保留所有权利。

Spinal chordomas are primary bone tumors where surgery remains the primary treatment. However, their low incidence, lack of evidence, and late disease presentation make them challenging to manage. Here, we report the postoperative outcomes of a large cohort of patients after surgical resection, investigate predictors for overall survival (OS) and local recurrence-free survival (LRFS) times, and trend functional outcomes over multiple time periods.Retrospective review of all patients followed for spinal chordoma at a quaternary spinal oncology center from 2003 to 2023 was included. Data were collected regarding demographics, preoperative and perioperative management, and follow-up since initial definitive surgery. Primary outcomes were OS and LRFS, whereas secondary outcomes were functional deficits.One hundred one patients had an average follow-up of 6.0 ± 4.2 years. At the time of census, 25/101 (24.8%) had experienced a recurrence and 10/101 (9.9%) had died. After surgery, patients experienced a significant decrease in pain over time, but rates of sensory deficits, weakness, and bowel/bladder dysfunction remained static. Tumors ≥100 cm3 (hazard ratio (HR) = 5.89, 95% CI 1.72-20.18, P = .005) and mobile spine chordomas (HR = 7.73, 95% CI 2.09-28.59, P = .002) are related to worse LRFS, whereas having neoadjuvant radiotherapy is associated with improved LRFS (HR = 0.09, 95% CI 0.01-0.88, P = .038). On the other hand, being age ≥65 years was associated with decreased OS (HR = 16.70, 95% CI 1.54-181.28, P = .021).Surgeons must often weigh the pros and cons of en bloc resection and sacrificing important but affected native tissues. Our findings can provide a benchmark for counseling patients with spinal chordoma. Tumors ≥100 cm3 appear to have a 5.89-times higher risk of recurrence, mobile spine chordomas have a 7.73 times higher risk, and neoadjuvant radiotherapy confers an 11.1 times lower risk for local recurrence. Patients age ≥65 years at surgery have a 16.70 times higher risk of mortality than those <65 years.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.