August 2026

NEUROSCIENCES

UPDATED GLOBAL CONSENSUS ON CHORDOMA MANAGEMENT

Featuring: Jean-Paul Wolinsky, MD
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Northwestern Medicine’s Jean-Paul Wolinsky, MD, neurosurgeon, and Rebecca Du, MD, chief resident in the Department of Neurological Surgery, were among the international experts who contributed to a new global consensus statement on the management of primary localized chordoma, published in JAMA Oncology. Updating landmark recommendations first released in 2015, the publication incorporates a decade of advances in molecular diagnostics, imaging, surgery, radiation therapy and supportive care.

Based on a review of 305 publications and developed by an international multidisciplinary panel, the guidance provides updated recommendations for diagnosis, treatment and follow-up, with a greater emphasis on personalized care and shared decision-making.

Key Updates to the Guidance

A major theme of the new consensus statement is the growing emphasis on shared decision-making, recognizing the importance of incorporating patient goals, treatment preferences and quality-of-life considerations into care planning. The guidance also introduces more detailed, site-specific recommendations for tumors involving the skull base, mobile spine and sacrum.
Notable updates include:
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  • Enhanced diagnostic and staging recommendations, including MRI of the primary tumor, whole-spine MRI, whole-body CT imaging and centralized pathology review when feasible.
  • Integration of molecular biomarkers, including brachyury and SMARCB1, to improve diagnostic accuracy and better define disease subtypes.
  • Expanded guidance on advanced radiation therapy, with increased support for highly conformal approaches such as proton and carbon ion therapy, as well as higher radiation doses than previously recommended.
  • Refined surgical recommendations, including site-specific treatment algorithms and updated guidance regarding surgical margins for spinal and sacral tumors.
  • More nuanced recommendations for systemic therapy, clarifying when these treatments may be appropriate for localized disease.
  • Greater emphasis on survivorship and supportive care, including rehabilitation, symptom management and long-term follow-up tailored to disease subtype and patient age.

Read the publication >
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Jean-Paul Wolinsky, MD, vice chair of Strategy and Operations in the Department of Neurological Surgery and professor of Neurological Surgery and Orthopaedic Surgery at Northwestern Medicine, was among the international experts who contributed to the development of the guidance.

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