2nd year Medical Student University of British Columbia, British Columbia, Canada
Introduction: Given the rarity of skull-based chondrosarcomas (SBCs), there exists a dearth in the literature regarding the longitudinal health-related quality of life (HRQoL) of patients following surgical management approaches. This study investigates the progression of long-term HRQoL outcomes following surgical resection and adjuvant proton beam therapy (PBT) management for SBCs using the SF-36 and reported clinical presentations as proxies.
Methods: Between 2002 and 2022, 20 patients with SBCs were diagnosed and treated by a single surgeon through elective surgery at our institution. Retrospective chart review was performed to gather preoperative and first postoperative (1PO) clinical presentation signs/symptoms and SF-36 scores. 1PO was approximately 6 weeks following surgery and prior to adjuvant PBT delivery. Prospective SF-36 scores will be collected to evaluate longitudinal QoL outcomes.
Results: Preoperatively, mean patient age was 56.7 years and mean tumour size was 3.49 cm. Patients with larger tumor sizes demonstrated improvement in General Health SF-36 scores at 1PO (pre operative rho -0.38, 1PO rho -0.22). Compared to the healthy Canadian average SF-36 scores, preoperative SF-36 scores were lower for all domains excluding Bodily Pain. Following surgery, only Role Emotional and Mental Health domains of the SF-36 showed improvement. Clinical presentation changes in preoperative and 1PO revealed an absolute risk increase in hearing reduction (40%, p< 0.05) and swallowing difficulties (15%, p< 0.05), with absolute risk reduction in diplopia (50%, p< 0.05) and headache (30%, p< 0.05).
Conclusion : Clinical symptoms at 1PO demonstrated absolute risk reduction of diplopia and headache. SF-36 scores 1PO are lower than preoperative for all domains excluding Role Emotional and Mental Health. Relative stability in QHRoL measures was observed where differences in SF-36 scores preoperative and 1PO failed to meet clinically minimal important thresholds. To appreciate longitudinal HRQoL impacts, prospective SF-36 scores will be collected to account for PBT completion and recovery period effects.
