Artikel
Extent of surgical resection but not histopathological subtype affects prognosis in low-grade lumbo-sacral ependymomas
Prognose lumbo-sakraler Ependymome in Abhängigkeit von Resektionsgrad und Histologie
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Even though the prognostic impact of histological subtype in ependymal tumors of lumbo-sacral location has not been systematically addressed, spinal ependymomas are classified as grade II WHO, whereas myxopapillary ependymomas are categorized as grade I WHO. We therefore aimed at investigating the influence of clinical characteristics as well as histopathology on recurrence.
Methods: Surgical specimens from 78 lumbo-sacral ependymal tumors were histopathologically reviewed and correlated with clinical data on extent of surgical resection, adjuvant treatment and postoperative clinical course.
Results: 52 myxopapillary ependymomas, 8 ependymal tumors displaying both myxopapillary and non-myxopapillary areas and 18 ependymomas were diagnosed. Median age of the 48 males and 30 females was 41 years (range 7-81). Gross total resection could be achieved in 88% of the cases. Upon a mean follow-up of 42 months, only two patients had died, both from non-tumor-related causes. Nine patients experienced recurrent tumor growth. On univariate analysis, extent of surgical resection (p<0.001), but not histopathological subtype were associated with recurrence-free survival. On multivariate analysis, only gross total resection remained an independent predictor of recurrence (p<0.01).
Conclusions: Irrespective of histopathological diagnosis, prognosis upon gross total resection was excellent in this series of lumbo-sacral ependymal tumors. Our data provide no justification to grade myxopapillary ependymoma and ependymoma of lumbo-sacral location differently.