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
