[Spinal cord astrocytomas and ependymomas: therapeutic strategy]

Ependymomas and astrocytomas are the most frequent spinal cord tumors. They have the same clinical expression and the only treatment is surgery. We report the experience of two neurochurgical teams working in Lyon and Brussels with 171 operated patients, focusing on therapeutic strategies. Spinal cord ependymomas usually present as circumscribed benin tumors, complete exeresis is the best strategy. Long-term follow-up in 40 patients who were not given adjuvant radiotherapy showed no recurrence and satisfactory functional results. Astrocytomas are classically less well circumscribed but when exeresis is macroscopically complete, results are comparable with those of ependymomas as was found in 22 patients with long-term follow-up. Inversely, for infiltrating astrocytomas, pathology is usually malignant and prognosis is unfavorable despite radiotherapy or chemotherapy.