Abstract
Objective: Chordoma is a rare, locally invasive malignant bone neoplasm originating from notochordal vestiges. However, long-term outcome data remain limited. Radical surgical excision and radiation therapy constitute the primary therapeutic approaches, whereas systemic treatments have demonstrated only marginal efficacy. This investigation sought to examine the clinical attributes, therapeutic approaches, and survival determinants in chordoma cases managed across two decades at a tertiary medical facility in Türkiye.
Material and Methods: A retrospective review was conducted of 18 patients diagnosed with chordoma from 2003 through 2024. Essential data, encompassing demographic, histological, and intervention particulars, were retrieved from the hospital archives. Survival metrics—such as overall survival (OS), progression-free survival (PFS1-3), local recurrence-free survival (LRFS), and metastasis-free survival (MFS)—were estimated using the Kaplan-Meier method. The influence of therapeutic and clinical parameters was evaluated using univariate Cox proportional hazards analyses.
Results: The median participant age stood at 53.5 years, with males constituting 72.2% of the cohort. The median observation duration was 96.2 months. Primary surgery was performed in 15 patients (83.3%), while 80% of patients received supplementary radiotherapy. Median OS (mOS) and PFS1 intervals were 45.3 months and 19.5 months, respectively. Subjects undergoing radiation exhibited significantly longer OS and PFS than non-irradiated counterparts (p<0.05). Complete (R0) excision correlated with a substantially extended LRFS (27.7 versus 3.6 months, p=0.002). Systemic treatment was associated with a marginal improvement in post-relapse survival (p=0.064). Lesion dimensions, patient age, and sex lacked a meaningful association with survival outcomes.
Conclusion: This two-decade institutional survey highlights the pivotal importance of thorough surgical resection and adjuvant radiation therapy in improving prognosis for chordoma patients. Noteworthy survival advantages emerged even with standard photon-based radiotherapy. Timely detection, extensive surgical debulking, and combined-modality strategies remain fundamental to optimizing prognosis in this malignancy. Expanded collaborative research initiatives are essential to further delineate therapeutic protocols and elucidate the utility of systemic agents.