Artikel
Microsurgery for spinal cord ependymomas
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Veröffentlicht: | 16. April 2008 |
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Gliederung
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Introduction: To evaluate the oncological outcome of patients with a spinal cord ependymoma, who were treated with microsurgery.
Materials and methods: Between 1987 and 2007, 55 patients (33 men, 22 women) underwent surgical therapy for a spinal cord ependymoma at our institution. Median follow-up was 38 (range: 1 – 195) months. Patients`charts, operative and histological reports were analysed. The neurological status of the patients was recorded using the McCormick grading system. Standard therapy consisted of a complete tumor resection whenever feasible.
Results: Pre-operatively, 1 patient was in McCormick grade 4, 13 patients in grade 3, 27 in grade 2 and 14 in grade 1. Post-operatively, 2 patients were in grade 4, 9 in grade 3, 27 in grade 2, 16 in grade 1 and in 1 patient the data were missing. Histopathological findings were ependymoma WHO grade I (myxopapillary) in 17 patients, ependymoma grade II in 35 patients, and WHO grade III (anaplastic) epndymoma in 3 patients. Only patients with grade III ependymomas received adjuvant therapy: radiation therapy in two cases, and radiation therapy and chemotherapy at tumor recurrence 3 years later in another case. Recurrent tumor was diagnosed in 6/55 (11%) patients including 4 patients with a myxopapillary ependymoma, and 1 patient with a grade II and III ependymoma each.
Conclusion: Functional outcomes after surgical therapy for spinal cord ependymomas are generally good. Recurrence rates ranging from 18-40 % have been reported in the literature. Our results (recurrence rate 11%) compare favourably with these numbers. Prognosis after surgery for myxopapillary ependymomas seems worse than generally believed.