Gender Differences in Treatment and Survival in Spinal Chordoma Patients

Introduction: Spinal chordoma is a rare malignancy of the spinal cord that affects approximately 350 people/year in the U.S. The aim of this study was to identify gender differences in disease treatment and survival in spinal chordoma patients.

Methods: A retrospective cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER) Program databases for the years 2000 to 2020. All adult patients diagnosed with spinal chordoma with primary sites in the vertebral column or sacrum/pelvis were included, based on the World Health Organization (WHO) International Classification of Diseases for Oncology 3rd Edition (ICD-O-3). Patients were stratified by gender.

Results: Of the 791 patients included, 485 were male, and 306 were female. Mean tumor sizes were similar between both groups (Male: 75.07  44.57, Female: 71.73  43.85, p=0.377). A higher proportion of females were single (Male: 31.6, Female: 45.7, p< 0.001). The location of the tumor was similar between both genders (Male: 42.3, Female: 42.5, p=0.953). The proportion of those who underwent surgery was similar between cohorts (Male: 73.4, Female: 73.2, p=0.951), while a greater proportion of men received radiation after surgery (Male: 82.0, Female: 77.2, p=0.011). Median survival in months was similar between both groups (Male: 106 [87, 139, Female: 83 [58, 119], p=0.230). While gender was not associated with increased or decreased hazard, Hispanic race was associated with increased risk of death in patients with spinal chordoma of the pelvis (hazard ratio 2.06 [1.42, 2.99], p< 0.001).

Conclusion : Our study found that among patients with spinal chordoma, gender differences were minimal. Similar percentages of males and females received surgery, and survival was similar between groups. Further studies may elucidate any covert underlying differences.