Global Consensus on the Management of Primary Localized Chordoma.

Authors

Stefano Radaelli, Anna M Frezza, Piero Fossati, Giacomo G Baldi, Toru Akiyama, Jose M Asencio, Stephanie Bolle, Judith V M G Bovee, Augusto T Caraceni, Gregory M Cote, Nicolas Dea, Angelo P Dei Tos, Francesco Doglietto, Rebecca Du, Juan C Fernandez-Miranda, Marco Ferrari, Adrienne M Flanagan, Paul A Gardner, Ziya L Gokaslan, Vinai Gondi, Matthew Hall, Hillary R Kelly, Nicole Lange, Paolo Lasalvia, Roberto Lillini, Carola Lütgendorf-Caucig, Shannon M MacDonald, Juan A Martín Benlloch, Diego Mazzatenta, Erin L McKean, Minesh P Mehta, Christina Messiou, Bernhard Meyer, Carlo Morosi, Sean Polster, Kristin J Redmond, Jeremy Reynolds, Francesca Ricchini, Andrew Rosenberg, Lisa M Ruppert, Arjun Sahgal, Daniela Salvatore, Joseph H Schwab, Daniel M Sciubba, Rajeev D Sen, Matija Snuderl, Josh Sommer, Patricia Sullivan, Beate Timmermann, Annalisa Trama, Andrea Vanzulli, Eduardo Vellutini, Damien C Weber, Mary F Wedekind, Jean-Paul Wolinsky, Yoshiya Yamada, Silvia Stacchiotti, Alessandro Gronchi, Global Chordoma Consensus Group

Published in

JAMA oncology. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

Chordoma is a rare malignant bone tumor with high local recurrence, metastatic spread in 40% to 60% of patients over the disease course, and significant morbidity. Because of its rarity, anatomical complexity, and prolonged natural history, high-quality evidence to guide management is limited. International consensus guidelines for localized chordoma were first published in 2015; however, advances in pathology, imaging, surgery, radiotherapy, and supportive care since then necessitate updated multidisciplinary recommendations.
To update and expand the 2015 consensus recommendations on the diagnosis, treatment, and follow-up of pediatric and adult patients with primary, localized chordoma.
In June 2025, a meeting of the Global Chordoma Consensus Group was held in Milan, Italy, that included experts from all relevant specialties as well as patient representatives. A comprehensive literature review guided structured discussions on the management of primary localized disease. Levels of evidence and grades of recommendation were assigned.
A total of 305 articles were included in the literature review. Management strategies were stratified by anatomical site (skull base, mobile spine, and sacrum). The central principal of care was treatment at experienced, multidisciplinary centers, with maximally safe surgery followed by high-dose, highly conformal radiotherapy. Guidance was provided on diagnosis, surgical approaches, and radiotherapy planning for each anatomical site. Systemic therapy options; long-term, risk-adapted follow-up; and supportive, palliative, and rehabilitative care were also addressed.
This global consensus statement provided updated multidisciplinary guidance for the management of primary, localized chordoma. It aimed to harmonize clinical practice, support shared decision-making, and identify priorities for future collaborative research in this rare and challenging disease.

PMID:
42424068
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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