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Spinal ependymoma with regional metastasis at presentation
Niv Pencovich1, Gyang Bot, Zvi Lidar
1Pediatric Neurosurgery, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 64239, Israel.
Acta Neurochirurgica
|March 8, 2014
Summary
Spinal ependymomas with regional metastases (SERMP) show a generally benign course. Complete tumor removal is ideal, but not at all costs, and adjuvant radiotherapy offers no proven benefit.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Spinal cord ependymomas are common glial neoplasms.
- Regional dissemination of spinal ependymomas is rare, lacking a standard treatment.
- This study evaluates management and outcomes of spinal ependymoma with regional metastases at presentation (SERMP).
Purpose of the Study:
- To retrospectively evaluate the management and outcomes of patients diagnosed with SERMP.
- To determine the efficacy of surgical resection and adjuvant radiotherapy in SERMP.
- To analyze prognostic factors influencing disease progression in SERMP.
Main Methods:
- Retrospective analysis of 16 patients diagnosed and treated for SERMP between 2002 and 2012.
- Patients were categorized into myxopapillary ependymomas (MPE) and other low-grade ependymomas.
- Outcomes assessed included postsurgical recurrence, progression, and survival.
Main Results:
- 13 of 16 patients experienced no recurrence or progression after surgery.
- Gross total removal (GTR) of the primary tumor and metastases did not correlate with improved progression-free survival in the MPE group.
- Other low-grade ependymomas showed an advantage, and adjuvant radiotherapy was not beneficial.
Conclusions:
- SERMP generally follows a benign clinical course.
- Gross total removal (GTR) is preferred but should be balanced against risks, especially for MPE near the conus medullaris.
- The benefit of adjuvant radiotherapy for SERMP remains unproven.
