Chordoma. Thirty-five-year study at Memorial Hospital.

Abstract

The clinical histories of 46 cases of chordoma seen and treated at Memorial Hospital from 1930 to 1965 are reviewed, including 30 cases of sacral origin, ten cases of vertebral origin, five sphenoidal and one extranotochordal, with an age range from 2 1/2 years to 71 and a male sex predominance of 32 to 14. Only three patients in this series are alive and free of disease 5, 13 and 16 years after diagnosis and treatment and the absolute 5-year survival rate with freedom from disease is only 8.7%. Complete surgical excision can result in a cure in a few selected sacrococcygeal or sphenoidal cases but incomplete removal or tumor spillage in the wound are certain to lead to recurrence and probable metastasis and death. When radiation therapy is employed, either alone or preoperatively, symptomatic relief can be expected and some regression in the tumor at least for a time. In those tumors that show some radioresponsiveness repeat x-ray dosages may prove of extended benefit. The authors conclude that distant metastasis and local recurrence are more common than ordinarily considered and therapeutic doses of supervoltage irradiation pre- or postoperatively could be of subtantial benefit in the management of this uncommon disease.