Article
Intramedullary spinal cord ependymoma: Analysis of 82 adult cases
Search Medline for
Authors
-
N. Aghakhani
- Service de Neurochirurgie, Hôpital de Bicêtre
-
P. David
- Service de Neurochirurgie, Hôpital de Bicêtre
-
F. Parker
- Service de Neurochirurgie, Hôpital de Bicêtre
-
C. Lacroix
- Laboratoire de Neuropatologie, Hôpital de Bicêtre
-
M . Tadie
- Service de Neurochirurgie, Hôpital de Bicêtre
| Published: | May 4, 2005 |
|---|
Outline
Text
Objective
To report and analyze a series of 82 intramedullary spinal cord ependymomas.
Methods
Clinical and MRI carachteristics , surgical findings and out come of 82 adult patients with intramedullary spinal cord ependymomas are reported. Factors determining clinical out-come and survival are discussed. Literature concerning the usfullness of radiotherapy is analyzed.
Results
There were 37 (45,1%) women and 45 men (54,9%),whose age ranged from 17 to 70 years (average age 42,8). The follow-up period ranged from 26 to 209 months ( median 76 months). Complete tumor removal was performed in 91.5% of patients.Postoperative neurological worsening showed usually progressive but dramatic improvement. There were only 2 malignant ependymomas. Finally 35% of patients were improved compared to their preoperative neurological status and 50% were stabilized. Radiotherapy was never used in case of benign ependymomas, even the resection was subtotal and we deplore only one case of tumoral progression. The best predicator of out-come is the preoperative neurological status.
Conclusions
Between hands of experienced surgeon, intramedullary spinal cord ependymomas, are in majority of cases totally and safely resectable using microsurgical techniques. Postoperative worsening of neurological status , which is constant, show usually dramatic improvement over weeks our months. Preoperative neurological status and the quality of tumor resection are the most important factor determining out-come. MRI is the technique of choice for diagnosis and postoperative survey of patients with intramedullary ependymomas. Radiotherapy has no place for totally resected tumors. In case of subtotal tumor removal, they are no clear data proving his usefulness, we suggest in these case an attentive survey and a second operation in case of tumor progression. Intramedullary ependymomas remain also an surgically treated entity and surgical results are satisfactory if patients are operated in specialized centers.
