Long-term Outcome After Resection of Intraspinal Ependymomas: Report of 86 Consecutive Cases
Long-term Outcome After Resection of Intraspinal Ependymomas: Report of 86 Consecutive Cases
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DOI：
10.1227/neu.0b013e3181f96d41
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发表时间：
2010-12-01
期刊：
影响因子：
4.8
通讯作者：
Helseth, Eirik
中科院分区：
文献类型：
--
作者：
Halvorsen, Charlotte Marie;Kolstad, Frode;Helseth, Eirik
背景：目的：评价连续86例椎管内室管膜瘤患者的无进展生存率、总生存率(OS)和长期临床结果。存活的患者自愿参加临床病史和体格检查，重点是神经功能和目前的肿瘤状态。结果：随访数据几乎100%完成，平均随访时间82个月。85名患者(99%)将手术作为一线治疗；其中14名患者(17%)接受了辅助放射治疗。在85例接受初次手术的患者中，60例(71%)进行了大体全切除，25例(29%)进行了次全切除。10年无进展生存率为75%，5年生存率为97%，10年生存率为91%。术前神经功能减退和确诊时年龄增大与死亡风险显著相关。在随访中，19例患者中有7例(37%)在初次手术后残留肿瘤可能发生了自发消退。超过75%的患者在随访时具有与独立生活相容的神经功能。良好的术前神经功能与良好的预后显著相关。目前尚不能评估放射治疗对无进展生存率和OS的影响。结论：大体全切除仍是脊椎室管膜瘤的最佳治疗方法。患者应定期接受临床检查和磁共振成像监测，最长可达术后10年。
BACKGROUND: Objective: To evaluate progression-free survival, overall survival (OS) and long-term clinical outcome in a consecutive series of 86 patients with intraspinal ependymomas.METHODS: Medical charts were retrospectively reviewed. Surviving patients voluntarily participated in a clinical history and physical examination that focused on neurological function and current tumor status.RESULTS: Follow-up data are nearly 100% complete; mean follow-up time was 82 months. Eighty-five patients (99%) had surgery as a first-line treatment; 14 (17%) of these patients received adjuvant radiotherapy. Of the 85 patients who underwent primary surgery, gross total resection was performed in 60 patients (71%) and subtotal resection in 25 patients (29%). Ten-year progression-free survival rate was 75%; 5-year OS, 97%; and 10-year OS, 91%. Reduced preoperative neurological function and older age at diagnosis were significantly associated with increased risk of death. At follow-up, spontaneous regression of residual tumor after primary surgery may have occurred in 7 of 19 patients (37%). More than 75% of patients had neurological function compatible with an independent life at follow-up. Good preoperative neurological function was significantly associated with favorable outcome. It was not possible to evaluate the effect of radiotherapy on progression-free survival and OS.CONCLUSION: Gross total resection remains the optimal treatment for patients with spinal ependymoma. Patients should be monitored with a clinical examination and magnetic resonance imaging at regular intervals up to 10 years after surgery.