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J Neurol Surg B Skull Base
DOI: 10.1055/a-2360-9857
Original Article

Longitudinal Quality-of-Life Outcomes of Skull Base Chondrosarcoma Patients following Surgical Resection

Seika Taniguchi 
1   Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
,
Jeremy Kam
1   Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
2   Division of Neurosurgery, Department of Surgery, Vancouver General Hospital, Vancouver, BC, Canada
3   Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria Australia
,
Castle-Mendel Kirszbaum
3   Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria Australia
,
Ryojo Akagami
1   Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
2   Division of Neurosurgery, Department of Surgery, Vancouver General Hospital, Vancouver, BC, Canada
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Abstract

Objective Owing to the rarity of skull base chondrosarcomas (CS), much of its natural history and long-term impact on patient quality of life (QoL) are not well studied. This novel study demonstrates QoL among CS patients following radical treatment constituting surgery and postoperative radiotherapy over 2 decades.

Study Design Retrospective review and prospective data collection to obtain patient demographic, tumor characteristics, clinical symptoms, and patient-reported QoL outcomes using the 36-Item Short Form Health Survey (SF-36).

Setting/Participants Patients diagnosed with CS who underwent radical intent surgical resection by the senior author and adjuvant early postoperative proton beam therapy.

Results Twenty-eight skull base CS patients were identified, with 19 patients completing full treatment course. Mean long-term follow-up was 148.9 months. Diplopia symptom resolution was high. No significant deterioration in SF-36 Physical Health Component (PHC) and Mental Health Component (MHC) scores was observed at postoperative and long-term follow-up. General health was stable initially but deteriorated in long term (Δ −18.88, minimal clinically important difference [MCID]: 9.86, p = 0.04). Compared with age-matched Canadian control patients, CS patients reported similar PHC scores at baseline and follow-up. CS patients reported lower MHC scores (45.8 vs. 50.9, p = 0.13) preoperatively, which persisted at follow-up decreasing by 1.9 (43.9 vs. 53.7, p = 0.03); this difference, however, did not reach MCID threshold of Δ 5.9.

Conclusion We present the longest follow-up data on CS demonstrating stable long-term QoL with aggressive surgery. Tumor control was high and preoperative tumor size did not affect long-term QoL. Preoperative QoL was lower among CS compared with Canadian normative data. Postoperatively, only the decline in physical functioning QoL scores exceeded MCID. At long-term follow-up, the decline in physical functioning, social functioning, and general health exceeded MCID. Overall, QoL among CS patients remained lower at long-term follow-up despite absence of tumor progression and resolution of symptoms.

Keywords

chondrosarcoma - quality of life - skull base tumor - SF-36 - skull base oncology

Presentations

Abstract publication and poster in 2023 Los Angeles American Association of Neurological Surgeons (AANS) meeting; abstract publication and oral presentation in 2024 North American Skull Base Society (NASBS) meeting.




Publication History

Received: 20 March 2024

Accepted: 03 July 2024

Accepted Manuscript online:
05 July 2024

Article published online:
22 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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