Intramedullary ependymoma: long-term outcome after surgery

Area of Science:

• Neurosurgery
• Oncology
• Spinal Cord Tumors

Background:

• Overall survival (OS) and progression-free survival (PFS) for spinal ependymomas are well-documented.
• However, specific data on OS and PFS for purely intramedullary ependymomas (IEs) remain limited.

Purpose of the Study:

• To determine the overall survival and progression-free survival rates for patients with intramedullary ependymomas.
• To identify factors influencing survival outcomes in patients undergoing surgical resection of IEs.

Main Methods:

• Retrospective analysis of 37 patients who underwent resection of an intramedullary ependymoma between January 2000 and December 2016.
• Evaluation of progression-free survival (PFS) and overall survival (OS) based on extent of resection, pre-operative clinical status, and other factors.

Main Results:

• Progression-free survival (PFS) at 5, 10, and 15 years was 87%, 82%, and 82%, respectively.
• Overall survival (OS) at 5, 10, and 15 years was 97%, 88%, and 63%, respectively.
• Gross total resection (GTR) significantly improved PFS, and pre-operative clinical status (McCormick grade) significantly impacted OS.

Conclusions:

• Gross total resection (GTR) is the most critical factor for achieving favorable progression-free survival (PFS) in intramedullary ependymomas (IEs).
• Overall survival (OS) for IEs is generally poorer compared to other spinal ependymomas.
• Patients with a good pre-operative clinical status (McCormick grade 1-2) exhibit significantly better OS than those with higher grades (McCormick grade 3+).