After evaluation, your chordoma care team will meet to discuss your test results and make recommendations for a treatment plan. Chordoma treatment typically involves both surgery and radiation therapy.
Chordoma surgeries are challenging because of the locations of these tumors. The goal for both skull base and sacral chordomas is to remove as much of the tumor as possible and all in one piece, if possible, which means part or all of a bone may need to be removed. The larger the tumor and the more bone that is removed, the more risk there is for loss of function or nerve damage. If surgery is the chosen treatment, complete tumor removal means better long-term outcomes. You and your care team will carefully consider the risks and benefits of surgery.
Depending on the complexity of the surgery, the procedure takes at least six hours and sometimes may need to be performed over the course of two days. Multiple surgeons may be involved, including orthopaedic, brain, head and neck, spine, general, and plastic surgeons. You will need to stay in the hospital for up to a week.
For skull base chordomas, surgeons may be able to use minimally invasive techniques through the nasal passages to reach the tumor. In these cases, you will have no visible scarring, a shorter hospital stay, and a quicker recovery.
Duke radiation oncologists may recommend targeted courses of radiation therapy before surgery to shrink the tumor or after surgery to kill any remaining cancer cells. All radiation therapy is provided on an outpatient basis, so no hospital stay is required.
Chordomas have about a 30% to 50% chance of recurrence. And, because the cancer is so slow-growing, it can metastasize years after successful treatment. We follow a strict surveillance schedule to catch any regrowth as soon as possible. For the first two years, you’ll be asked to return regularly for follow-up appointments and imaging scans. After that, appointments will space out incrementally over the next eight years.