gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Surgical treatment of spinal ependymomas in adults: results over a period of 15 years

Meeting Abstract

  • M. Nakamura - Klinik für Neurochirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
  • F. Wild - Klinik für Neurochirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
  • B. Hong - Klinik für Neurochirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
  • H.E. Heissler - Klinik für Neurochirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
  • J.K. Krauss - Klinik für Neurochirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.02.04

DOI: 10.3205/11dgnc179, URN: urn:nbn:de:0183-11dgnc1793

Published: April 28, 2011

© 2011 Nakamura 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: Spinal ependymomas in adults are rare. However, they represent 60% of intramedullary tumors. We report on our surgical series of 44 adult patients with spinal ependymomas, who underwent surgery between January 1995 and January 2010 at our neurosurgical department.

Methods: Clinical and radiological data were retrospectively collected from patient charts, imaging studies and follow-up records. Surgeries were perfomed using microsurgical techniques.

Results: This study included 44 patients (20 men, 24 women). 42 patients had a WHO grade I or II tumor, 2 patients a WHO grade III tumor. Tumors were located in the cervical or thoracic spinal cord in 30 patients and in the conus medullaris or cauda equina in 14 patients. The most common presenting symptoms were sensory disturbance or pain. Among patients with an intramedullary cervical or thoracic ependymoma (n = 30), 10 patients (33.3%) presented with a paraparesis preoperatively. In 80% of the cases, the motor function could be preserved at the same level. Long-term follow-up showed that motor function improved in 40% of cases. Median preoperative Karnofsky-score was 90% compared to 80% postoperatively. A total tumor resection was achieved in 34 of 44 patients (77.3%). A new postoperative paraparesis was observed in 2 patients (4.5%) and postoperative tracheotomy was necessary in 2 patients (4.5%). Perioperative mortality was 4.5%. After complete tumor resection (n = 34), there was 1 recurrence (5.9%) after 121 months and following incomplete resection 3 recurrences (30%) after a mean of 32 months (24 - 40 months) (p = 0.0044). Postoperative radiotherapy was performed in 6 of 44 patients (13.6%) including 4 patients, who underwent incomplete tumor resection. There was no recurrence after a mean follow-up time of 99.2 months (24 - 168 months). The total mean follow-up time was 74.4 months (9 - 204 months) in this surgical series.

Conclusions: The radicality of tumor resection in spinal ependymomas is a significant factor for the tumor recurrence rate. Although none of the patients with postoperative radiotherapy have had a recurrent tumor so far, the role of radiotherapy cannot be answered in our retrospective surgical series.