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The Stephan L. Harris Center provides compassionate care while advancing the art and science of evaluating, diagnosing, treating, curing, and supporting patients with chordoma.
The Harris Center brings the Cancer Center’s multidisciplinary expertise to the evaluation, treatment, and support of chordoma patients. An advisory group bringing together specialists throughout Mass General has been established to support this goal and advance the search for a cure. “As part of that effort, we are building a chordoma care information center on our website that we hope will be a resource for patients and physicians internationally,” notes Dr. Francis Hornicek, who directs the Harris Center.
The Stephan L. Harris Center is a center of excellence at the Massachusetts General Hospital that provides unsurpassed compassionate care while advancing the art and science of evaluating, diagnosing, treating, curing, and supporting the patient with chordoma.
Each patient in our program is evaluated and cared for by a multidisciplinary team of experts who specialize in the diagnosis and treatment of chordoma.
These specialists include:
When Stephan Harris was diagnosed with recurrent chordoma, he and his wife traveled from abroad to seek the best possible care. They consulted with specialists at several major U.S. cancer centers, and chose Massachusetts General Hospital and Henry J. Mankin, then chair of the Orthopaedics, because of his world-renowned chordoma expertise.
Dr. Mankin subsequently referred him to Frank X. Pedlow, MD, orthopaedic surgeon, and Frederick G. Barker, MD, neurosurgeon. As Mr. Harris’ disease unfortunately progressed, Francis J. Hornicek, MD, PhD, now chief of the Orthopaedic Oncology Service and Co-director of the Center for Sarcoma and Connective Tissue Oncology, also became involved in his care.
After Harris’s death, his wife made a major gift in his honor to establish the Stephan L. Harris Center for Chordoma Care at the Massachusetts General Hospital Cancer Center. “I made this gift to help other people with this disease, and to create a place where they know there will be doctors and nurses, as well as other families, who understand what they are going through,” she said. “My husband wanted to do this too.”
Mrs. Harris had previously given generously to support chordoma research at Mass General. She felt that the place and timing were right to establish this first center in the world with a single focus on chordoma care because Dr. Hornicek and his team had already committed themselves to chordoma research.
In addition, Mrs. Harris’s gift established a fund to help families receiving care at the Harris Center with transportation and housing expenses. “When my husband was sick, I was able to travel with him so he would not be alone,” she says. “Stephan would have wanted to help others travel with their families for treatment.” This assistance, notes Anne Fiore, NP, is already helping families and patients, freeing them to focus on treatment and healing. “The Harris Center is helping us extend the expert level of care available here at Mass General to chordoma patients around the world,” adds Dr. Hornicek.
Welcome to the Stephan L. Harris Center for Chordoma Care at Massachusetts General Hospital. Our multidisciplinary group of physicians and clinicians specializes in the diagnosis and treatment of chordoma.
The team of clinicians at Mass General represents one of the largest chordoma treatment groups in the world.
When a patient is referred to the Harris Center at Mass General, he or she is asked to bring all pertinent records and radiology studies that have been completed with them to their visit.
Patients are seen in our multidisciplinary clinic, where all aspects of care are available in one location. This unique one-stop clinical care unit helps patients get the comprehensive care they need without having to leave the clinic.
Treatment providers coordinated through our team approach include orthopedic oncology surgeons, radiation oncologists, medical oncologists, neurosurgeons, reconstructive surgeons, radiologists, pathologists and nurse practitioners who specialize in the diagnosis and treatment of chordoma.
Patients have access to the most technically sophisticated treatments available for chordoma.
To contact us for an appointment or new patient referall, the new patient coordinator, at 617-724-8193.
Click here to download the Harris Chordoma Center Brochure
The Stephan L. Harris Center for Chordoma Care is dedicated to providing unsurpassed compassionate care for your patient while advancing the art and science of evaluating, diagnosing, treating, curing, and supporting the patient with chordoma.
Providing care for a chordoma patient is complex and time-consuming. We have found that the most effective treatment and care can be given by a team of specialists working together.
A team approach is important in dealing with:
To refer a patient to the Harris Center, please call the Connie Peters, the patient coordinator, at 617-724-8193 or by email.
Chordoma is a rare, slow-growing malignant tumor believed to arise from cellular remnants of the notochord. The treatment of chordomas is difficult. Wide surgical excision is desirable, but it is rarely feasible based on the anatomic location of the tumor at the base of the skull or the base of the spine.
Currently there are no effective drugs for chordoma, and there are no drugs currently approved to treat chordoma. Unlike with other types of sarcoma, there is no specific known tumor-suppressor gene or oncogene associated with chordoma.
There is a need, however, for understanding the molecular biology of chordoma. We have obtained a number of chordoma cell lines. Most importantly, the Massachusetts General Hospital Sarcoma Group has archived more than 150 cases of chordoma tissues and paraffin blocks in our tissue bank. DNA, RNA and protein samples from chordoma tumor tissues will be analyzed by CGH or SNP array, gene and protein expression profile with the hope of identification of chordoma susceptibility genes or pathways.
The new discoveries from these studies will identify potential tumor-suppressor genes and oncogenes, then proteins for testing in chordoma tissues. We plan to determine the efficacy of targeting mTOR, Stat3 expression in chordoma cells by small molecular compounds, siRNA and to evaluate its effect on chordoma cell growth, proliferation and apoptosis.
Our goal is to be able to identify new molecular targets, assess new therapeutics, and better characterize the prognosis of chordomas.
The following articles are a selection of publications from Harris Center researchers from 2000 to 2014, arranged in chronological order with the most recent at the top. Click on a title for the PubMed summary of the article.
How Does the Level of Nerve Root Resection in En Bloc Sacrectomy Influence Patient-Reported Outcomes? van Wulfften Palthe OD1, Houdek MT, Rose PS, Yaszemski MJ, Sim FH, Boland PJ, Healey JH , Hornicek FJ, Schwab JH, Clin Orthop Relat Res. 2016 Mar 18
Characteristics and Patterns of Metastatic Disease from Chordoma Young VA, Curtis KM, Temple HT, Eismont FJ, DeLaney TF, Hornicek FJ, Sarcoma. 2015;2015:517657.
CSPG4 as a prognostic biomarker in chordoma Schoenfeld AJ, Wang X, Wang Y, Hornicek FJ, Nielsen GP, Duan Z, Ferrone S, Schwab JH. Spine J. 2015 Dec 9. pii: S1529-9430(15)
Chordoma: an update on the pathophysiology and molecular mechanisms Sun X, Hornicek F, Schwab JH. Curr Rev Musculoskelet Med. 2015 Dec;8(4):344-52.
High-dose proton-based radiation therapy in the management of spine chordomas: outcomes and clinicopathological prognostic factors. Rotondo RL , Folkert W, Liebsch NJ, Chen YL , Pedlow FX , Schwab JH , Rosenberg AE , Nielsen GP , Szymonifka J, Ferreira AE, Hornicek FJ , DeLaney TF . (2015) J Neurosurg Spine. 2015 Dec;23(6):788-97.
[18F]-Fluoromisonidazole Positron Emission Tomography/Computed Tomography Visualization of Tumor Hypoxia in Patients With Chordoma of the Mobile and Sacrococcygeal Spine. Cheney MD, Chen YL, Lim R, Winrich BK, Grosu AL, Trofimov AV, Depauw N, Shih HA, Schwab JH, Hornicek FJ, DeLaney TF. Int J Radiat Oncol Biol Phys. 2014 Dec 1;90(5):1030-6.
Long-term results of Phase II study of high dose photon/proton radiotherapy in the management of spine chordomas, chondrosarcomas, and other sarcomas. DeLaney TF, Liebsch NJ, Pedlow FX, Adams J, Weyman EA, Yeap BY, Depauw N, Nielsen GP, Harmon DC, Yoon SS, Chen YL, Schwab JH, Hornicek FJ. J Surg Oncol. 2014 Aug;110(2):115-22.
Genotyping Cancer-Associated Genes in Chordoma Identifies Mutations in Oncogenes and Areas of Chromosomal Loss Involving CDKN2A, PTEN, and SMARCB1. Choy E, MacConaill LE, Cote GM, Le LP, Shen JK, Nielsen GP, Iafrate AJ, Garraway LA, Hornicek FJ, Duan Z. PLoS One. 2014 Jul 1;9(7)
Prognostic significance of miRNA-1 (miR-1) expression in patients with chordoma. Duan Z, Shen J, Yang X, Yang P, Osaka E, Choy E, Cote G, Harmon D, Zhang Y, Nielsen GP, Spentzos D, Mankin H, Hornicek F.J Orthop Res. 2014 May;32(5):695-701
Tissue microarray immunohistochemical detection of brachyury is not a prognostic indicator in chordoma. Zhang L, Guo S, Schwab JH, Nielsen GP, Choy E, Ye S, Zhang Z, Mankin H, Hornicek FJ, Duan Z.PLoS One. 2013 Sep 23;8(9)
Definitive High Dose Photon/Proton Radiotherapy for Unresected Mobile Spine and Sacral Chordomas. Chen YL, Liebsch N, Kobayashi W, Goldberg S, Kirsch D, Calkins G, Childs S, Schwab J, Hornicek F, Delaney T. Spine (Phila Pa 1976). 2013 Apr 19
Establishment and characterization of a novel chordoma cell line: CH22. Liu X, Nielsen GP, Rosenberg AE, Waterman PR, Yang W, Choy E, Sassi S, Yang S, Harmon DC, Yang C, Schwab JH, Kobayashi E, Mankin HJ, Xavier R, Weissleder R, Duan Z, Hornicek FJ. J Orthop Res. 2012 Apr 13. doi: 10.1002/jor.22113
Extended dermal apposition: a simple technique for the closure of irradiated perineal and sacral wounds. Hartzell TL, Medina M, Hornicek FJ, Austen WG Jr. Plast Reconstr Surg. 2011 Jun;127(6):170e-3e
Recurrent chromosomal copy number alterations in sporadic chordomas Le LP, Nielsen GP, Rosenberg AE, Thomas D, Batten JM, Deshpande V, Schwab J, Duan Z, Xavier RJ, Hornicek FJ, Iafrate AJ. PLoS One. 2011;6(5):e18846. Epub 2011 May 13
Nanoparticles: a promising modality in the treatment of sarcomas. Susa M, Milane L, Amiji MM, Hornicek FJ, Duan Z.Pharm Res. 2011 Feb;28(2):260-72. Epub 2010 May 27.
Proteomic profiling of chordoma. DeLaney TF, Duan Z, Hornicek FJ. J Surg Oncol. 2010 Dec 1;102(7):719. doi: 10.1002/jso.21766
Characterization and analysis of human chordoma cell lines Yang C, Hornicek FJ, Wood KB, Schwab JH, Choy E, Iafrate J, Rosenberg A, Nielsen GP, Xavier RJ, Mankin H, Duan Z. Spine 2010 Jun 1;35(13):1257-64
Blockage of Stat3 With CDDO-Me Inhibits Tumor Cell Growth in Chordoma Yang C, Hornicek FJ, Wood KB, Schwab JH, Choy E, Mankin H, Duan Z. Spine 2010 Apr 9. [Epub ahead of print]PMID: 20386502 [PubMed - as supplied by publisher]
Differential expression of microRNA (miRNA) in chordoma reveals a role for miRNA-1 in met expression Duan Z, Choy E, Nielsen G, Rosenberg A, Iafrate J, Yang C, Schwab J, Mankin H, Xavier R, Hornicek F. Journal of Orthopedic Research 2009 Dec 29
Sacral Chordoma Farsad K, Kattapuram SV, Sacknoff R, Ono J, Nielsen GP. Radiographics. 29(5):1525-30, 2009 Sep-Oct.
A novel target for treatment of chordoma: signal transducers and activators of transcription 3 Yang C, Schwab JH, Schoenfeld AJ, Hornicek FJ, Wood KB, Nielsen GP, Choy E, Mankin H, Duan Z. Mol Cancer Ther 2009 Sep;8(9):2597-605.
Combination of PI3K/mTOR inhibition demonstrates efficacy in human chordoma. Schwab J, Antonescu C, Boland P, Healey J, Rosenberg A, Nielsen P, Iafrate J, Delaney T, Yoon S, Choy E, Harmon D, Raskin K, Yang C, Mankin H, Springfield D, Hornicek F, Duan Z. Anticancer Res. 2009 Jun;29(6):1867-71. PMID: 19528441 [PubMed - in process]
Aberrant hyperactivation of akt and Mammalian target of rapamycin complex 1 signaling in sporadic chordomas. Han S, Polizzano C, Nielsen GP, Hornicek FJ, Rosenberg AE, Ramesh V. Clin Cancer Res. 2009 Mar 15;15(6):1940-6. Epub 2009 Mar 10. PMID: 19276265
Combination short-course preoperative irradiation, surgical resection, and reduced-field high-dose postoperative irradiation in the treatment of tumors involving the bone. Wagner TD, Kobayashi W, Dean S, Goldberg SI, Kirsch DG, Suit HD, Hornicek FJ, Pedlow FX, Raskin KA, Springfield DS, Yoon SS, Gebhardt MC, Mankin HJ, Delaney TF. Int J Radiat Oncol Biol Phys. 2009 Jan 1;73(1):259-66. PMID: 19100921
Phase II study of high-dose photon/proton radiotherapy in the management of spine sarcomas. DeLaney TF, Liebsch NJ, Pedlow FX, Adams J, Dean S, Yeap BY, McManus P, Rosenberg AE, Nielsen GP, Harmon DC, Spiro IJ, Raskin KA, Suit HD, Yoon SS, Hornicek FJ. Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):732-9. Epub 2008 Dec 25. PMID: 19095372
Chordoma and chondrosarcoma gene profile: implications for immunotherapy. Schwab JH, Boland PJ, Agaram NP, Socci ND, Guo T, O'Toole GC, Wang X, Ostroumov E, Hunter CJ, Block JA, Doty S, Ferrone S, Healey JH, Antonescu CR. Cancer Immunol Immunother. 2009 Mar;58(3):339-49. Epub 2008 Jul 19. PMID: 18641983
The surgical pathology of notochordal remnants in adult intervertebral disks: a report of 3 cases. Wang WL, Abramson JH, Ganguly A, Rosenberg AE. Am J Surg Pathol. 2008 Aug;32(8):1123-9. PMID: 18545146
Brachyury expression in extra-axial skeletal and soft tissue chordomas: a marker that distinguishes chordoma from mixed tumor/myoepithelioma/parachordoma in soft tissue. Tirabosco R, Mangham DC, Rosenberg AE, Vujovic S, Bousdras K, Pizzolitto S, De Maglio G, den Bakker MA, Di Francesco L, Kalil RK, Athanasou NA, O'Donnell P, McCarthy EF, Flanagan AM. Am J Surg Pathol. 2008 Apr;32(4):572-80. PMID: 18301055
Intraosseous benign notochord cell tumors (BNCT): further evidence supporting a relationship to chordoma. Deshpande V, Nielsen GP, Rosenthal DI, Rosenberg AE. Am J Surg Pathol. 2007 Oct;31(10):1573-7. PMID: 17895760
Clonality studies in sacral chordoma. Klingler L, Trammell R, Allan DG, Butler MG, Schwartz HS. Cancer Genet Cytogenet. 2006 Nov;171(1):68-71. PMID: 17074594
Base of skull chordomas in children and adolescents: a clinicopathologic study of 73 cases. Hoch BL, Nielsen GP, Liebsch NJ, Rosenberg AE. Am J Surg Pathol. 2006 Jul;30(7):811-8. PMID: 16819322
Sacral chordomas: Impact of high-dose proton/photon-beam radiation therapy combined with or without surgery for primary versus recurrent tumor. Park L, Delaney TF, Liebsch NJ, Hornicek FJ, Goldberg S, Mankin H, Rosenberg AE, Rosenthal DI, Suit HD. Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1514-21. Epub 2006 Jun 6. PMID: 16757128
Sarcoma and skin radiation oncology. Nedea EA, DeLaney TF. Hematol Oncol Clin North Am. 2006 Apr;20(2):401-29. Review. PMID: 16730300
Corroboration of a familial chordoma locus on chromosome 7q and evidence of genetic heterogeneity using single nucleotide polymorphisms (SNPs). Yang XR, Beerman M, Bergen AW, Parry DM, Sheridan E, Liebsch NJ, Kelley MJ, Chanock S, Goldstein AM. Int J Cancer. 2005 Sep 1;116(3):487-91. PMID: 15818627
Spinal cord tolerance to high-dose fractionated 3D conformal proton-photon irradiation as evaluated by equivalent uniform dose and dose volume histogram analysis. Marucci L, Niemierko A, Liebsch NJ, Aboubaker F, Liu MC, Munzenrider JE. Int J Radiat Oncol Biol Phys. 2004 Jun 1;59(2):551-5. PMID: 15145175
Anterior spinal arthrodesis with structural cortical allografts and instrumentation for spine tumor surgery. Lewandrowski KU, Hecht AC, DeLaney TF, Chapman PA, Hornicek FJ, Pedlow FX. Spine (Phila Pa 1976). 2004 May 15;29(10):1150-8; discussion 1159. Review. PMID: 15131446
Clinical outcome in chordoma: utility of flow cytometry in DNA determination. Berven S, Zurakowski D, Mankin HJ, Gebhardt MC, Springfield DS, Hornicek FJ. Spine (Phila Pa 1976). 2002 Feb 15;27(4):374-9. PMID: 11840103
Chordoma periphericum: a case report. Nielsen GP, Mangham DC, Grimer RJ, Rosenberg AE. Am J Surg Pathol. 2001 Feb;25(2):263-7. PMID: 11176077
Role of onlay grafting with minimal internal fixation for occipitocervical fusion in oncologic patients. Sanpakit S, Mansfield TL, Liebsch J. J Spinal Disord. 2000 Oct;13(5):382-90. PMID: 11052346
Harris Center staff (from left to right): Al Ferreira, RN; Anne Fiore, DNP; Francis Hornicek, MD, PhD
“In chordoma patients of non-skull base who have not had prior treatment our center, using aggressive surgical and radiation therapy has not had a local recurrence”
"It is a privilege and unique opportunity to participate in the care of chordoma patients."
"The clinical management of patients with chordomas warrants a multidisciplinary approach. The surgeries are technically, physically and emotionally demanding. Each patient must be closely followed for many years and this allows for the development of a close personal relationship between physician and patient. It is this relationship where the reward truly lies."
"Helping patients through a diagnosis and treatment of chordoma has been the most rewarding experience of my 30 year career as a nurse"
“Chordoma patients need to be taken care of by a multidisciplinary team experienced in the specialized care of these patients. Few centers of excellence exist where these rare tumors are treated. The initial effort in managing their disease is our best chance at obtaining a positive outcome.”
"We have developed improved surgical techniques, as well as sophisticated radiation therapy techniques, including protons, that clearly have improved our ability to control these tumors, as documented in our recent publications."
“To manage a disease as rare and challenging as chordoma, you need a high volume chordoma center where world leaders in chordoma biology, surgery, radiation, pathology, radiology and nursing can all work closely together in a seamless fashion. MGH has exactly such a center.”
"One point regarding chordoma treatment that cannot be overemphasized: evaluation and treatment by a group of highly specialized physicians with extensive experience in the management of the chordomas is absolutely critical, because the best chance to eradicate the tumor is at the time of initial treatment."
Orthopaedic Oncology Surgeon
Orthopaedic Spine Surgeon & Orthopaedic Oncology Surgeon
For inquiries or assistance, please contact Al Ferreira, RN, at 617-643-7241 or by email.
If you are coming from outside the United States please contact the International Patient Center first for assistance in arranging your visit.
To make an appointment, or for inquiries or assistance, contact the patient coordinator at 617-724-8193
The Harris center is located on the main Mass General campus in the Yawkey Center for Outpatient Care, Yawkey 3B, 55 Fruit St, Boston Mass 02114.
EDUCATIONDegree in Nursing from Northeastern University.MAJOR CONTINUING EDUCATION COURSESWaltham Hospital - Critical Care Course Deaconess Hospital - Intra Aortic Balloon Pump CourseHarvard Medical School - Mini Course in Critical Care MedicineMidas Rex Institute - Modern Dissection Techniques in Bone, Biometals, and Bioplastics.COMMITTEE MEMBERSHIPSPACU Education and Quality Assurance CommitteesOR JCAHO preparation committeeOR Redesign Committee Center to track surgical timesJordan Hospital Y2K committeePerioperative CommitteeProduct Standardization CommitteePROFESSIONAL ORGANIZATIONSNational Association of Orthopaedic Nurses PUBLICATIONS Sullivan, E., Veilleux, R., Sherry, V., Lanchester, J. Ferreira, A. (2009) Development and Implementation of a Perioperative Tracking Program. Poster at ASPAN conference. Ferreira. A. (1991) Current concepts in sepsis. Greater Boston Chapter of the American Association of Critical Care Nurses Chronicle. Ferreira. A. (1984) Postoperative management in adult liver transplantation. Bulletin of the Mass. Society of Post Anesthesia Nurses. Rotondo RL , Folkert W, Liebsch NJ, Chen YL , Pedlow FX , Schwab JH , Rosenberg AE , Nielsen GP , Szymonifka J, Ferreira AE, Hornicek FJ , DeLaney TF . (2015) High-dose proton-based radiation therapy in the management of spine chordomas: outcomes and clinicopathological prognostic factors. J Neurosurg Spine. 2015 Dec;23(6):788-97. After graduating from Northeastern University, Al’s 30-year clinical career includes working in critical care, post-anesthesia, perioperative, and orthopedic nursing. In addition, he has worked as a clinical analyst in information systems and as a perioperative informatics consultant for two software firms.
EDUCATIONDoctor of Nursing Practice (DNP), Simmons CollegeUndergraduate and Graduate degrees: Boston College, Chestnut Hill, MACLINICAL DEPARTMENTSOrthopaedic Oncology SurgeryCenter for Sarcoma and Connective Tissue OncologyStephan L. Harris Center for Chordoma CareCLINICAL INTERESTSPediatric and Adult benign and malignant (sarcoma) bone and soft tissue tumorsPatient Education: encompassing knowledge of the disease, adjuvant treatment, surgery and rehabilitation Pain ManagementAnne Fiore began her nursing career at Mass General Hospital in 1978, specializing in the care of children and adolescents with benign and malignant bone and soft tissue tumors. She began as a staff nurse and held various nursing positions through subsequent years, including Clinical Teacher and Clinical Nurse Specialist. She joined the Department of Orthopaedics, Orthopaedic Oncology Surgery, in 1992. Her passion through the years has been patient education: preparing patients and their families for treatment of their tumors, for surgical management and adjuvant therapy. She has been a consistent source of support for these patients over the past 17 years.Anne had the privilege of caring for Mr. Stephan Harris. At the time of his diagnosis, management of chordoma was primarily surgery. Now, treatment has dramatically improved, involving a ‘team approach’, all focused on chordoma care, including musculoskeletal pathologists and radiologists, oncology surgeons (ortho, neuro, ENT, general), medical and radiation oncologists, nurse practitioners and nurses specializing in surgical/medical oncology.Anne was honored to coordinate the first ‘Chordoma Clinic’ in the newly established ‘Stephan l. Harris Center for Chordoma Care’ on April 02, 2009. Watching patients interact with each other and supporting each other gave her great pleasure, since the goal of the Center, according to Mrs. Harris is “to help other people with this disease and to create a place where they know there will be doctors and nurses, as well as other families, who understand what they are going through”.We all know how supportive the presence of a loved one/family member is to the overall care of a patient. Anne recalls that Mr. Harris was never alone; his wife was by his side at all times. Thus, as part of Mrs. Harris’ major gift to establish the Center for Chordoma Care, she created a fund for patients to assist them with travel and housing expenses. The positive impact this has had on patients and families is overwhelming; there are no words to express their gratitude. This assistance has freed them to focus their energy on treatment and healing. Anne Fiore’s goal is to work closely with the Chordoma Center Nurse Coordinator, Al Ferreira, to extend the level of expert care available at Mass General to chordoma patients around the world. She will continue to support, educate, coordinate treatment, and manage care of this difficult disease for chordoma patients and their families.
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