Chordoma: an analysis of twenty cases treated over a twenty-year span.

Chordoma is a recurring malignancy which does not play by the rules. A five-year survival or even a survival of ten years or longer without evidence of tumor cannot assure the surgeon that the malignant growth has been laid to rest. Recurring local episodes as well as metastases may continue to yield to surgery, irradiation, and other forms of treatment for an astonishing length of time. Thus, situations that may be cause for despair in other malignancies are often a challenge for renewed vigorous treatment in chordoma.