Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study

Objective: Spinal cord ependymomas account for 3–6% of all central nervous system tumors and around 60% of all intramedullary tumors. The aim of this study was to analyze the neurological outcome after surgery and to determine prognostic factors for functional outcome. Patients and Methods: Patients...

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Autores principales:	Oliver Gembruch, Mehdi Chihi, Merle Haarmann, Ahmet Parlak, Marvin Darkwah Oppong, Laurèl Rauschenbach, Anna Michel, Ramazan Jabbarli, Yahya Ahmadipour, Ulrich Sure, Philipp Dammann, Neriman Özkan
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f84c921d310e4df2ab2e5c357df976fe
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spelling	oai:doaj.org-article:f84c921d310e4df2ab2e5c357df976fe2021-11-11T23:03:31ZSurgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study1756-286410.1177/17562864211055694https://doaj.org/article/f84c921d310e4df2ab2e5c357df976fe2021-11-01T00:00:00Zhttps://doi.org/10.1177/17562864211055694https://doaj.org/toc/1756-2864Objective: Spinal cord ependymomas account for 3–6% of all central nervous system tumors and around 60% of all intramedullary tumors. The aim of this study was to analyze the neurological outcome after surgery and to determine prognostic factors for functional outcome. Patients and Methods: Patients treated surgically due to a spinal cord ependymoma between 1990 and 2018 were retrospectively included. Demographics, neurological symptoms, radiological parameters, histopathology, and neurological outcome (using McCormick Score [MCS]) were analyzed. Possible prognostic factors for neurological outcome were evaluated. Results: In total, 148 patients were included (76 males, 51.4%). The mean age was 46.7 ± 15.3 years. The median follow-up period was 6.8 ± 5.4 years. The prevalence was mostly in the lumbar spine (45.9%), followed by the thoracic spine (28.4%) and cervical spine (25.7%). Gross-total resection was achieved in 129 patients (87.2%). The recurrence rate was 8.1% and depended on the extent of tumor resection ( p = 0.001). Postoperative temporary neurological deterioration was observed in 63.2% of patients with ependymomas of the cervical spine, 50.0% of patients with ependymomas of the thoracic spine, and 7.4% of patients with ependymomas of the lumbosacral region. MCS 1–2 was detected in nearly two-thirds of patients with cervical and thoracic spinal cord ependymoma 36 months after surgery. Neurological recovery was superior in thoracic spine ependymomas compared with cervical spine ependymomas. Poor preoperative functional condition (MCS >2), cervical and thoracic spine location, and tumor extension >2 vertebrae were independent predictors of poor neurological outcome. Conclusion: Neurological deterioration was seen in the majority of cervical and thoracic spine ependymomas. Postoperative improvement was less in thoracic cervical spine ependymomas compared with thoracic spine ependymomas. Poor preoperative status and especially tumor extension >2 vertebrae are predictors of poor neurological outcome (MCS >2).Oliver GembruchMehdi ChihiMerle HaarmannAhmet ParlakMarvin Darkwah OppongLaurèl RauschenbachAnna MichelRamazan JabbarliYahya AhmadipourUlrich SurePhilipp DammannNeriman ÖzkanSAGE PublishingarticleNeurology. Diseases of the nervous systemRC346-429ENTherapeutic Advances in Neurological Disorders, Vol 14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Oliver Gembruch Mehdi Chihi Merle Haarmann Ahmet Parlak Marvin Darkwah Oppong Laurèl Rauschenbach Anna Michel Ramazan Jabbarli Yahya Ahmadipour Ulrich Sure Philipp Dammann Neriman Özkan Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
description	Objective: Spinal cord ependymomas account for 3–6% of all central nervous system tumors and around 60% of all intramedullary tumors. The aim of this study was to analyze the neurological outcome after surgery and to determine prognostic factors for functional outcome. Patients and Methods: Patients treated surgically due to a spinal cord ependymoma between 1990 and 2018 were retrospectively included. Demographics, neurological symptoms, radiological parameters, histopathology, and neurological outcome (using McCormick Score [MCS]) were analyzed. Possible prognostic factors for neurological outcome were evaluated. Results: In total, 148 patients were included (76 males, 51.4%). The mean age was 46.7 ± 15.3 years. The median follow-up period was 6.8 ± 5.4 years. The prevalence was mostly in the lumbar spine (45.9%), followed by the thoracic spine (28.4%) and cervical spine (25.7%). Gross-total resection was achieved in 129 patients (87.2%). The recurrence rate was 8.1% and depended on the extent of tumor resection ( p = 0.001). Postoperative temporary neurological deterioration was observed in 63.2% of patients with ependymomas of the cervical spine, 50.0% of patients with ependymomas of the thoracic spine, and 7.4% of patients with ependymomas of the lumbosacral region. MCS 1–2 was detected in nearly two-thirds of patients with cervical and thoracic spinal cord ependymoma 36 months after surgery. Neurological recovery was superior in thoracic spine ependymomas compared with cervical spine ependymomas. Poor preoperative functional condition (MCS >2), cervical and thoracic spine location, and tumor extension >2 vertebrae were independent predictors of poor neurological outcome. Conclusion: Neurological deterioration was seen in the majority of cervical and thoracic spine ependymomas. Postoperative improvement was less in thoracic cervical spine ependymomas compared with thoracic spine ependymomas. Poor preoperative status and especially tumor extension >2 vertebrae are predictors of poor neurological outcome (MCS >2).
format	article
author	Oliver Gembruch Mehdi Chihi Merle Haarmann Ahmet Parlak Marvin Darkwah Oppong Laurèl Rauschenbach Anna Michel Ramazan Jabbarli Yahya Ahmadipour Ulrich Sure Philipp Dammann Neriman Özkan
author_facet	Oliver Gembruch Mehdi Chihi Merle Haarmann Ahmet Parlak Marvin Darkwah Oppong Laurèl Rauschenbach Anna Michel Ramazan Jabbarli Yahya Ahmadipour Ulrich Sure Philipp Dammann Neriman Özkan
author_sort	Oliver Gembruch
title	Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
title_short	Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
title_full	Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
title_fullStr	Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
title_full_unstemmed	Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
title_sort	surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/f84c921d310e4df2ab2e5c357df976fe
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Surgical outcome and prognostic factors in spinal cord ependymoma: a single-center, long-term follow-up study

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