分期

脊索瘤分期

诊断为脊索瘤后,下一步通常是确定癌症的程度。这也被称为癌症分期。分期是医务人员用来描述体内癌症数量和癌症位置的过程。影像学检查可以帮助测量肿瘤。可能进行活检来检查癌细胞。医护团队会使用癌症分期来帮助制定治疗计划。

脊索瘤分期可能使用不同系统。举例来说,这些系统包括:

  • Enneking 系统,包括三个分期。
  • 美国癌症联合会(AJCC)系统,包括四个分期。

分期术语

脊索瘤的分期通常会考虑几个因素。AJCC 系统将其称为 T、N 和 M:

  • T. 肿瘤的大小。
  • N. 肿瘤是否已扩散至附近组织或淋巴结。
  • M. 癌症是否已扩散至身体其他部位。

无论使用哪种分期系统,分期数越低,意味着癌症进展程度越低。这意味着肿瘤较小,生长缓慢,且尚未从原始肿瘤区域扩散。分期数越高,意味着癌症越大、生长越快或已经扩散。

医务人员还会在显微镜下观察肿瘤细胞的侵袭性。这被称为肿瘤等级(G)。

无论使用哪种分期系统,等级数越低,意味着癌症侵袭性越低、生长越慢。等级数越高,意味着癌症侵袭性越高、生长越快。

  • Enneking 系统有两个等级。
  • AJCC 系统有四个等级。

分期还可能包括脊索瘤的类型,因为这可能与其侵袭性有关。去分化和低分化型脊索瘤往往比常规(也称为经典和典型)脊索瘤或软骨样脊索瘤更具侵袭性。软骨样脊索瘤往往比传统脊索瘤更具侵袭性。

您可能听说过“终末期脊索瘤”一词。它是指无法治愈或通过治疗加以管理的脊索瘤。终末期癌症治疗的重点是控制疼痛和其他症状,以提高舒适度。

脊索瘤预后

癌症预后告诉您癌症治愈的可能性。医护团队可以根据分期大致了解您的预后。但分期无法预知未来。您的个人预后可能取决于:

  • 活检结果。
  • 手术期间可以切除多少肿瘤。
  • 癌症的分期和分级。

如果您想了解预后情况,请咨询医护团队。医护团队成员可以解释他们在评估您的预后时考虑哪些因素。

Oct. 17, 2025

Living with 脊索瘤?

Connect with others like you for support and answers to your questions in the Sarcoma support group on Mayo Clinic Connect, a patient community.

Sarcoma Discussions

rgotto41
Synovial sarcoma: Proton or conventional radiation after surgery?

16 Replies Tue, May 12, 2026

Colleen Young, Connect Director
Diagnosed with sarcoma? Let's share

1065 Replies Thu, May 07, 2026

rond306
My biopsy is scheduled soon on my upper right thigh (sarcoma)

49 Replies Mon, Apr 27, 2026

See more discussions
  1. Elsevier Point of Care. Clinical Overview: Rare central nervous system tumors. https://www.clinicalkey.com. Accessed Nov. 20, 2024.
  2. Bone cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1418. Accessed Aug. 21, 2025.
  3. Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Nov. 20, 2024.
  4. Zenonos GA. Chordoma of the skull base. https://www.uptodate.com/contents/search. Accessed Aug. 21, 2025.
  5. Chordoma. National Cancer Institute. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-bone-tumors/chordoma. Accessed Aug. 21, 2025.
  6. Barber SM, et al. Chordoma — Current understanding and modern treatment paradigms. Journal of Clinical Medicine. 2021; doi:10.3390/jcm10051054.
  7. Banks C, et al. ICAR: Endoscopic skull-base surgery. International Forum of Allergy & Rhinology. 2019; doi:10.1002/alr.22326.
  8. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). RadiologyInfo.org. https://www.radiologyinfo.org/en/info/stereotactic. Accessed Jan. 29, 2025.
  9. Dickerson TE, et al. Recurrent metastatic chordoma to the liver: A case report and review of the literature. Current Oncology. 2022; doi:10.3390/curroncol29070367.
  10. Song PH, et al. Symptom burden and life challenges reported by adult chordoma patients and their caregivers. Quality of Life Research. 2017; doi:10.1007/s11136-017-1544-2.
  11. Young VA, et al. Clinical study: Characteristics and patterns of metastatic disease from chordoma. Sarcoma. 2015; doi:10.1155/2015/517657.
  12. Alshammari J, et al. Clival chordoma with an atypical presentation: A case report. Journal of Medical Case Reports. 2012; doi:10.1186/1752-1947-6-410.
  13. Dudhe S, et al. Challenging the giant: A case report on a huge sacrococcygeal chordoma and its radiological insights. Radiology Case Reports. 2025; doi:10.1016/j.radcr.2024.10.157.
  14. Zhou Y, et al. The clinical outcomes for chordomas in the cranial base and spine: A single center experience. Medicine. 2019; doi:10.1097/MD.0000000000015980.
  15. Medical oncologic treatment of spinal malignancies and outcomes. Video. Mayo Clinic; 2023.
  16. Murphey MD, et al. Imaging of spinal chordoma and benign notochordal cell tumor (BNCT) with radiologic pathologic correlation. Skeletal Radiology. 2023; doi:10.1007/s00256-022-04158-7.
  17. Baig Mirza A, et al. Surgical management of spinal chordoma: A systematic review and single-center experience. World Neurosurgery. 2021; doi:10.1016/j.wneu.2021.09.001.
  18. Court C, et al. Management of chordoma of the sacrum and mobile spine. Orthopaedics & Traumatology: Surgery & Research. 2022; doi:10.1016/j.otsr.2021.103169.
  19. Goumenos S, et al. Clinical outcome after surgical treatment of sacral chordomas: A single-center retrospective cohort of 27 patients. Cancers. 2024; doi:10.3390/cancers16050973.
  20. Garofalo F, et al. The unresolved case of sacral chordoma: From misdiagnosis to challenging surgery and medical therapy resistance. Annals of Coloproctology. 2014; doi:10.3393/ac.2014.30.3.122.
  21. Zhang J, et al. Intradural cervical chordoma with diffuse spinal leptomeningeal spread: Case report and review of the literature. European Spine Journal. 2018; doi:10.1007/s00586-017-5443-6.
  22. Passeri T, et al. The mutational landscape of skull base and spinal chordomas and the identification of potential prognostic and theranostic biomarkers. Journal of Neurosurgery. 2023; doi:10.3171/2023.1.JNS222180.
  23. Ma T, et al. Current understanding of brachyury in chordoma. BBA — Reviews on Cancer. 2023; doi:10.1016/j.bbcan.2023.189010.
  24. Elsamadicy AA, et al. The association of gender in the management and prognosis of vertebral and sacral chordoma: A SEER analysis. Journal of Clinical Medicine. 2025; doi:10.3390/jcm14051737.
  25. What is cancer? American Cancer Society. https://www.cancer.org/cancer/understanding-cancer/what-is-cancer.html. Accessed Aug. 31, 2025.
  26. Soule E, et al. Current management and image review of skull base chordoma: What the radiologist needs to know. 2021; doi:10.25259/JCIS_139_2021.
  27. CT scan. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675. Accessed Sept. 4, 2025.
  28. American College of Surgeons. Bone cancer. In: AJCC Cancer Staging System. American College of Surgeons; 2025. https://online.statref.com. Accessed Sept. 8, 2025.
  29. Dastgheyb SS, et al. A prospective phase I/II clinical trial of high-dose proton therapy for chordomas and chondrosarcomas. Advances in Radiation Oncology. 2024; doi:10.1016/j.adro.2024.101456.
  30. Childhood chordoma treatment (PDQ) — Health professional version. National Cancer Institute. https://www.cancer.gov/types/bone/hp/child-chordoma-treatment-pdq. Accessed Sept. 9, 2025.
  31. Immunotherapy. American Cancer Society. https://www.cancer.org/cancer/managing-cancer/treatment-types/immunotherapy/immune-checkpoint-inhibitors.html. Accessed Sept. 18, 2025.
  32. Shyam Sunder S, et al. Adverse effects of tyrosine kinase inhibitors in cancer therapy: Pathophysiology, mechanisms and clinical management. Signal Transduction and Targeted Therapy. 2023; doi:10.1038/s41392-023-01469-6.
  33. Cancer survival rate: What it means for your prognosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer/art-20044517. Accessed Sept. 18, 2025.
  34. Cancer survivors: Care for your body after treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-survivor/art-20044015. Accessed Sept. 18, 2025.
  35. Stacchioti S, et al. Best practices for the management of local-regional recurrent chordoma: A position paper by the Chordoma Global Consensus Group. Annals of Oncology. 2017; doi:10.1093/annonc/mdx05.
  36. Bone cancer. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bone-cancer/symptoms-causes/syc-20350217. Accessed Sept. 11, 2025.
  37. Steffner RJ, et al. Staging of bone and soft-tissue sarcomas. Journal of the American Academy of Orthopedic Surgeons. 2018; doi:10.5435/JAAOS-D-17-00055.
  38. Terminal cancer. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/terminal-cancer. Accessed Sept 12, 2025.
  39. Cancer pain: Relief is possible. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-pain/art-20045118. Accessed Sept. 18, 2025.
  40. Health Education & Content Services. Chordoma overview. Mayo Clinic; 2025.
  41. Sahgal A, et al. Image-guided, intensity-modulated radiation therapy (IG-IMRT) for skull base chordoma and chondrosarcoma: Preliminary outcomes. Neuro-Oncology. 2015; doi:10.1093/neuonc/nou347.
  42. Chhabra AM, et al. Proton therapy for spinal tumors: A consensus statement from the Particle Therapy Cooperative Group. International Journal of Radiation Oncology, Biology, Physics. 2024; doi:10.1016/j.ijrobp.2024.04.007.
  43. Maroufi SF, et al. Stereotactic radiosurgery in the management of skull base chordomas: A comprehensive systematic review and meta-analysis. Neurosurgical Focus. 2024; doi:10.3171/2024.2.FOCUS249.
  44. Ghaith, AK, et al. Impact of proton versus photon radiotherapy on overall survival in the management of spinal chordoma and mortality risk prediction: A nationwide analysis. Journal of Neuro-Oncology. 2025; doi:10.1007/s11060-025-05104-y.
  45. Myneni, S, et al. Exploring perspectives on skull base chordoma management: A modified Delphi approach to consensus. Journal of Neuro-Oncology. 2025; doi:10.1007/s11060-025-05088-9.
  46. Han Y, et al. Clinical differences among histological categories of sarcoma: Insights from 97,062 patients. Cancers (Basel). 2025; doi:10.3390/cancers17101706.
  47. Rodrigues ACLF, et al. Proton beam and carbon ion radiotherapy in skull base chordoma: A systematic review, meta-analysis and meta-regression with trial sequential analysis. Neurosurgical Review. 2024; doi:10.1007/s10143-024-03117-1.

相关

相关医疗程序

产品与服务

CON-20248515