Temporal Trends of Skull Base Chondroma and Chondrosarcoma-Related Mortality in the United States Population From 1999 to 2023: A Retrospective Analysis Using the CDC Wonder Database

Introduction: Chordoma is a notochordal-based malignant tumor that accounts for approximately 4 percent of primary bone tumors and 1 percent of tumors of brain tumors, with an incidence of 0.08/100,000. Chondrosarcoma, which accounts for 20-25 per cent of all malignant bone tumors, is especially prevalent in adults over 75 years of age and, as such, needs population-based mortality trend research. Methods: Using CDC WONDER mortality data (1999–2023), age-adjusted mortality rates (AAMR) per 1,000,000 people were analyzed for chordoma- and chondrosarcoma-related deaths. Cases were identified using the ICD-10 codes C40.1–C41.9. Trends were stratified by sex, race, census region, state, and urbanization, and annual percentage changes (APCs) were calculated using Joinpoint regression to assess temporal patterns. Results: Between 1999 and 2023, 28,138 deaths due to chordoma were reported in adults aged > 55 years. Males represented 55.1% and had consistently higher age-adjusted mortality rates (AAMR) than females. Racially, 22,723 (83.1%) were non-Hispanic (NH) white, 2,794 (10.2%) were NH Black, and 1,826 (6.7%) were Hispanic/Latino. The majority of deaths occurred at home (45.3%), followed by medical facilities (21.4%) and long-term facilities (19.4%). Overall, the adjusted rates per million declined from 14.27 in 1999 to 12.55 in 2012 (APC: 1.15, p = 0.009) and then increased markedly to 18.49 in 2021 (APC: 4.66, p = 0.016) before falling to 17.50 in 2023, representing an overall significant increase (AAPC: 0.83, p < 0.001). Males reached 24.60 in 2021 and decreased to 21.41 in 2023, while females increased consecutively from 9.29 in 2012 to 14.54 in 2023. NH Blacks experienced the highest absolute AAMR (20.86 in 2021), whereas NH Whites demonstrated the sharpest long-term increase (18.75 in 2023). Mortality exceeded most in the =75-year category (peak 39.18 in 2021). The non-metropolitan rates remained higher than the metropolitan rates (peak 23.66 vs 16.21 in 2020). The South exhibited the highest regional AAMR (peak 20.95, 2019). These results demonstrated increased mortality. Conclusion: Mortality due to chordoma has increased sharply since 2012, with consistent sex, race, age, and geographic disparities, which indicates a necessity for prevention with special emphasis on early detection and equal measures for health care. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany