15/10/2026
🦴 New Global Consensus Recommendations: Advancing the Management of Primary Localized Chordoma
AO Spine Knowledge Forum Tumor members are proud to have contributed to this landmark update, published in JAMA Oncology, on managing primary localized chordoma — led by the INT team and supported by the Chordoma Foundation, 150+ international experts, and patient advocates.
Building on the 2015 consensus, this update delivers clinically actionable, site-specific guidance for skull base, mobile spine, and sacral chordoma:
🔹 Refined surgery — supramarginal resection considered at the skull base when it can be performed without significantly increasing morbidity; en bloc resection principles in the spine and sacrum
🔹 Updated radiotherapy — dose, target volumes, and the role of particle-based approaches
🔹 SACRO trial interim results — supporting proton/carbon-ion radiotherapy as a primary option for select sacral chordoma patients
🔹 Subtype-adapted systemic therapy — chemo considered for poorly differentiated/dedifferentiated disease, not recommended for localized conventional chordoma
🔹 Risk-adapted follow-up and integrated rehabilitative care
Care at experienced, multidisciplinary centers and shared decision-making remain central — a strong example of what global collaboration can achieve for a rare disease.
🧾 Drs Nicolas Dea and Jeremy Reynolds look closer at the updates and why this was needed https://www.aofoundation.org/spine/about-aospine/Blog/2026/updated-global-consensus-on-chordoma
📖 Read it in JAMA Oncology: https://doi.org/10.1001/jamaoncol.2026.2054
🧑🏽⚕️A patient-facing version is also available for clinicians to share with their patients: https://www.chordomafoundation.org/treatment-guidelines/new-diagnosis/
