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目的通过总结颅底脊索瘤手术后生存、复发等特点,探讨颅底脊索瘤的长期预后。方法采用电话、信件、门诊复查方式对1993年5月至2005年6月期间接受手术治疗的106例颅底脊索瘤患者进行随访,应用远期生活质量评分(Karnofsky Performance Scale,KPS)对全部患者术前、出院前、随访时的生存状况进行评分,SPSS 生命表法计算生存率、复发率。结果 79例得到随访,随访时间10～158个月,平均63.9个月,本组1、3、5、10年复发率分别为19.1%、34.7%、52.9%和88.3%,本组1、3、5、10年生存率分别为87.2%、79.4%、67.6%、59.5%。入院时 KPS 平均评分71.0分,出院前 KPS 平均评分72.5分,最后随访 KPS 平均评分67.1分,与出院前评分存在显著差异(P=0.020)。结论颅底脊索瘤预后不良,术后复发率呈逐年上升趋势,术后生存率前7年呈阶梯状下降,第8年后有逐渐平稳的趋势。手术治疗可以改善多数患者的远期生活质量。
Objective To study the long-term prognosis of skull base chordoma by summarizing the survival and recurrence of skull base chordoma after operation. Methods A total of 106 cases of skull base chordoma undergoing surgery between May 1993 and June 2005 were followed up by phone, mail and outpatient review. The Karnofsky Performance Scale (KPS) Preoperative, pre-discharge, follow-up of living conditions were scored, SPSS life table method to calculate the survival rate, recurrence rate. Results 79 cases were followed up for 10 to 158 months with an average of 63.9 months. The recurrence rates at 1, 3, 5 and 10 years were 19.1%, 34.7%, 52.9% and 88.3% The 5-year and 10-year survival rates were 87.2%, 79.4%, 67.6% and 59.5% respectively. At admission, the average KPS score was 71.0 points, pre-discharge KPS average score 72.5 points, and the last follow-up KPS average score 67.1 points, which was significantly different from the pre-discharge score (P = 0.020). Conclusions The prognosis of skull base chordoma is poor. The postoperative recurrence rate is increasing year by year. The postoperative survival rate decreases stepwise in the first 7 years and gradually stabilizes after 8 years. Surgical treatment can improve long-term quality of life in most patients.