2024-03-29T02:04:28Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00026418
2023-01-16T04:16:59Z
499:500:501
Surgical outcomes of spinal cord and cauda equina ependymoma : Postoperative motor status and recurrence for each WHO grade in a multicenter study
Kobayashi, Kazuyoshi
Ando, Kei
Kato, Fumihiko
Kanemura, Tokumi
Sato, Koji
Kamiya, Mitsuhiro
Nishida, Yoshihiro
Ishiguro, Naoki
Imagama, Shiro
open access
© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Background: The goals of the study are to analyze postoperative outcomes and recurrence in cases of spinal cord and cauda equina ependymoma in each World Health Organization (WHO) Grade, and to examine the influence of extent of surgical removal on prognosis. Spinal ependymoma has a relatively high frequency among intramedullary spinal cord tumors. The tumor is classified in WHO guidelines as grades I, II, and III, but few studies have examined postoperative prognosis based on these grades. Methods: The records of 80 patients undergoing surgery for spinal cord and cauda equina ependymoma were examined in a multicenter study using a retrospective database. Neurological motor status, pathological type, extent of resection, and tumor recurrence were evaluated. Results: The histopathological types were grade I in 23 cases (myxopapillary: 21, subependymoma: 2), grade II in 52 cases, and grade III in 5 cases (including all anaplastic cases). Total resection was performed in 60 cases (83%), and eight cases had recurrence, including 2 in WHO grade I, 2 in grade II, and 4 in grade III. The 5-year recurrence-free survival rates were 90%, 91%, and 20% in grades I, II and III, respectively. Adjuvant radiotherapy for the local site was performed in 8 cases, including 3 in grade I and 5 in grade III; however, 4 of the 5 grade III cases (80%) had recurrence after radiotherapy. Among 59 patients with normal ambulation or independence without external assistance (McCormick Grade I or II), 53 (90%) maintained the same mobility after surgery. In cases that underwent total resection, the recurrence rate was significantly lower (p < 0.01). A good preoperative motor status also resulted in significantly better postoperative recovery of motor status (p < 0.05). Conclusions: Total resection of spinal cord and cauda equina ependymoma leads to postoperative motor recovery and may reduce tumor recurrence. Therefore, early surgery for this tumor is recommended before aggravation of paralysis.
ファイル公開:2019-07-01
Elsevier
2018-07
eng
journal article
AM
http://hdl.handle.net/2237/00028621
https://nagoya.repo.nii.ac.jp/records/26418
https://doi.org/10.1016/j.jos.2018.03.004
0949-2658
Journal of Orthopaedic Science
23
4
614
621
https://nagoya.repo.nii.ac.jp/record/26418/files/JOS.pdf
application/pdf
316.8 kB
2019-07-01