gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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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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  • corresponding author A. Jeibmann - Institut für Neuropathologie, Universitätsklinikum Münster
  • R. Egensperger - Institut für Pathologie and Neuropathologie, Universitätsklinikum Essen
  • H. Wassmann - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
  • W. Paulus - Institut für Neuropathologie, Universitätsklinikum Münster
  • M. Hasselblatt - Institut für Neuropathologie, Universitätsklinikum Münster

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 073

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc341.shtml

Published: May 30, 2008

© 2008 Jeibmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.