How is a chordoma managed and treated?

Surgery is the best option for chordomas located at the sacrum and in the mobile spine. Complete surgical removal tends to delay reoccurrence and is associated with longer survival rates. In these procedures, the tumors are removed along with tissue around it. This is generally followed by external-beam radiation treatments.

For clival chordomas and other skull-base chordomas, great effort is taken to save nerve function. This often involves doing surgery with special instruments and entering through the nose. It might not be possible to remove all of the tumor. Radiotherapy is used after surgery. However, the doses that are effective against the tumors are higher than can be tolerated by the spinal and brain tissues. Stereotactic radiosurgery, however, can deliver such high-dose radiation with lower risk to brain and nerve tissue than conventional fractionated radiotherapy, and may be an effective treatment in some cases.

Although tests are underway, chemotherapy does not seem to be effective against chordomas.

Last reviewed by a Cleveland Clinic medical professional on 09/05/2018.


  • Chauhan A, Ahluwalia V, Saharan P, Sharma N, Narayan S, Gupta R. RADIOLOGICAL CASE. Clival chordoma in a young child. Applied Radiology [serial online]. November 2017;46(11):37-41.
  • Thompson L. Chordoma. ENT: Ear, Nose & Throat Journal [serial online]. January 2011;90(1):16-18.
  • Tsuji T, Chiba K, Matsumoto M, et al. Differentiation of spinal giant cell tumors from chordomas by using a scoring system. European Journal Of Orthopaedic Surgery & Traumatology [serial online]. October 2016;26(7):779-784.
  • Young V, Curtis K, Temple H, Eismont F, DeLaney T, Hornicek F. Characteristics and Patterns of Metastatic Disease from Chordoma. Sarcoma [serial online]. December 30, 2015;:1-7.
  • Sawke G K, Sawke NG. Sacrococcygeal chondroid chordoma: A case report with brief literature review. Clin Cancer Investig J 2014;3:116-8
  • George B, Bresson D, Herman P, Froelich, S. Chordomas: A Review. Neurosurgery Clinics of North America, 2015-07-01, Volume 26, Issue 3, Pages 437-452, Copyright © 2015 Elsevier Inc.
  • Chordoma Foundation. Understanding Chordoma. Accessed 9/14/2018.
  • Bone Cancer Research Trust. Chordoma. Accessed 9/14/2018.

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