[Intramedullary astrocytomas: A French retrospective multicenter study]

Area of Science:

• Neurosurgery
• Oncology
• Neuropathology

Background:

• Intramedullary astrocytomas (IA) are primary spinal cord tumors requiring complex management.
• Multicenter studies with long-term follow-up are essential for understanding IA prognosis and treatment efficacy.

Purpose of the Study:

• To analyze clinical, radiological, surgical, and adjuvant treatment data for patients with intramedullary astrocytomas.
• To evaluate the long-term outcomes and survival rates of IA patients.

Main Methods:

• Retrospective analysis of 95 patients with pathologically confirmed IA operated on between 1984 and 2011 across 7 French centers.
• Clinical evaluation using the McCormick Scale (MCS) pre- and postoperatively; minimum follow-up of 12 months.
• Epidemiological analysis of the entire cohort; survival analysis focused on 54 patients from a single center for data homogeneity.

Main Results:

• The average age at diagnosis was 35.6 years, with neuropathic pain being the most common presenting symptom (76%).
• Complete tumor removal was achieved in 38% of cases at one center. Histological grades ranged from 1 (35%) to 4 (8%).
• Five-year survival for low-grade IA (grades 1 and 2) was 78.6%, and 10-year survival was 76.8%.

Conclusions:

• Surgical intervention is indicated for symptomatic IA or those with tumor progression.
• Radical excision, while challenging, remains the primary treatment goal, prioritizing motor function preservation.
• Regular postoperative follow-up and adjuvant therapies (chemotherapy, radiotherapy) are critical based on histological type.