Chordoma: long-term evaluation of 15 cases treated surgically.

A series of 15 patients affected with chordoma localized in the clivus and the vertebral column treated surgically by a single surgeon were studied. Localizations in the proximal segments of the spine (clivus and cervical spine) become clinically evident earlier. Diagnosis and consequent treatment are carried out during a stage of progression that is less advanced than occurs in chordomas with lumbar and sacral localization. Based on a study of the material examined it may be observed that factors influencing prognosis are related to the phase of progression of the disease (stage of the tumor), site, whether or not previous surgery has been performed. The type of surgical resection varies in relation to the site of the lesion, at times allowing for wide margin resections. The progressive course of the tumor is positively influenced by early diagnosis, currently favored by progress made in the field of neuroradiology, surgical resection performed according to oncological criteria, and conventional high-dosage radiation therapy, with fractioned doses.