Results following surgical resection of recurrent chordoma of the spine: experience in a single institution

BACKGROUND: Chordoma of the spine is a low-grade malignant tumor with vague and indolent symptoms; thus, large tumor mass is encountered at the time of diagnosis in almost cases and makes it difficult for en-bloc free-margin resection. Salvage therapy for recurrent chordoma is very challenging due to its relentless nature and refractory to adjuvant therapies. The aim of this present study was to report the oncologic outcome following surgical resection of chordoma of the spine. MATERIALS AND METHODS: Retrospective review of 10 consecutive cases of recurrent chordoma patients who underwent surgical treatment between 2003 and 2018 at one tertiary-care center was conducted. RESULTS: There were 10 patients; 4 females and 6 males were included in this study. Eight patients had local recurrence. The recurrence was encountered at the muscle, surrounding soft tissue, and remaining bony structure. Distant metastases were found in 2 patients. The median time to recurrence or metastasis was 30 months after first surgery. CONCLUSION: En-bloc free-margin resection is mandatory to prevent recurrence. The clinical vigilance and investigation to identify tumor recurrent should be performed every 3 to 6 months, especially in the first 30 months and annually thereafter. Detection of recurrent in early stage with a small mass may be the best chance to perform an en-bloc margin-free resection to prevent further recurrence.