Clinical characteristics and surgical outcomes of ependymomas in the upper cervical spinal cord: a single-center experience of 155 consecutive patients.

التفاصيل البيبلوغرافية
العنوان:	Clinical characteristics and surgical outcomes of ependymomas in the upper cervical spinal cord: a single-center experience of 155 consecutive patients.
المؤلفون:	Fei X; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China.; Department of Neurosurgery, The Affiliated Jiangyin People's Hospital of Southeast University Medical College, Wuxi, 214400, Jiangsu, China., Jia W; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China., Gao H; Department of Neurosurgery, The Affiliated Jiangyin People's Hospital of Southeast University Medical College, Wuxi, 214400, Jiangsu, China., Yang C; Department of Orthopedics, Peking University Third Hospital, Haidian District, Beijing, 100191, China., Li D; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China., Qian Z; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China., Han B; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China., Wang D; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China., Xu Y; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, 100070, China. xuhuxi@sina.cn.; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Fengtai District, Beijing, 100070, China. xuhuxi@sina.cn.
المصدر:	Neurosurgical review [Neurosurg Rev] 2021 Jun; Vol. 44 (3), pp. 1665-1673. Date of Electronic Publication: 2020 Aug 07.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Springer Berlin Heidelberg Country of Publication: Germany NLM ID: 7908181 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-2320 (Electronic) Linking ISSN: 03445607 NLM ISO Abbreviation: Neurosurg Rev Subsets: MEDLINE
أسماء مطبوعة:	Publication: Berlin : Springer Berlin Heidelberg Original Publication: Berlin : Walter De Gruyter
مواضيع طبية MeSH:	Cervical Cord/diagnostic imaging , Cervical Cord/surgery , Ependymoma/diagnostic imaging , Ependymoma/surgery , Spinal Cord Neoplasms/diagnostic imaging , Spinal Cord Neoplasms/surgery, Adult ; Aged ; Cohort Studies ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult
مستخلص:	Ependymomas occurring in the upper cervical spinal cord (above the level of the C4 segment) are rare entities with great therapeutic challenges. This study was aimed to investigate the clinicoradiological characteristics and the prognosis in a large cohort of upper cervical ependymomas from a single institution. This retrospective study enrolled 155 patients with primary ependymomas in the upper cervical spinal cord. The pre- and post-operative clinical and magnetic resonance imaging profiles were collected. The neurological outcomes and survival events were evaluated, and potential independent risk factors were analyzed. There were 82 females and 73 males, with an average age of 43.1 ± 11.3 years. Immediately post-operatively, 118 (76.1%) patients experienced neurological deterioration and 32 (20.7%) patients remained unchanged. Three months after surgery, 61 (39.4%) patients showed deteriorated neurological functions compared to the pre-operative baseline levels. After an average follow-up period of 56.0 ± 24.7 months, the neurological functions were worse than the baseline status in 37 (23.9%) patients and improved in 33 (21.3%) patients, respectively. Logistic regression analysis identified that lower age (≤ 42 years) and lower pre-operative MMS (I-II) were independent protective factors for predicting favorable neurological functions. Multivariate Cox regression analysis revealed that incomplete resection was the only independent risk factor associated with a shorter progression-free survival. Age and pre-operative functional status affect the long-term neurological outcomes, and incomplete resection was associated with a shorter survival. Our findings indicate that gross total resection should be the goal of surgical treatment of upper cervical ependymomas.
References:	Alizada O, Kemerdere R, Ulu MO, Akgun MY, Isler C, Kizilkilic O, Hanci MM (2020) Surgical management of spinal intramedullary tumors: ten-year experience in a single institution. J Clin Neurosci 73:201–208. https://doi.org/10.1016/j.jocn.2019.12.054. (PMID: 10.1016/j.jocn.2019.12.05431932186) Amirian ES, Armstrong TS, Aldape KD, Gilbert MR, Scheurer ME (2012) Predictors of survival among pediatric and adult ependymoma cases: a study using surveillance, epidemiology, and end results data from 1973 to 2007. Neuroepidemiology 39:116–124. https://doi.org/10.1159/000339320. (PMID: 10.1159/000339320228467893470871) Behmanesh B, Gessler F, Won SY, Dubinski D, Quick-Weller J, Imoehl L, Seifert V, Marquardt G (2020) Return to work and clinical outcome after surgical treatment and conservative management of patients with intramedullary spinal cord ependymoma. Sci Rep 10:2335. https://doi.org/10.1038/s41598-020-59328-1. (PMID: 10.1038/s41598-020-59328-1320472397012826) Bostrom A, von Lehe M, Hartmann W, Pietsch T, Feuss M, Bostrom JP, Schramm J, Simon M (2011) Surgery for spinal cord ependymomas: outcome and prognostic factors. Neurosurgery 68:302–308; discussion 309. https://doi.org/10.1227/NEU.0b013e3182004c1e. (PMID: 10.1227/NEU.0b013e3182004c1e21135741) Brotchi J, Fischer G (1998) Spinal cord ependymomas. Neurosurg Focus 4:e2. https://doi.org/10.3171/foc.1998.4.5.5. (PMID: 10.3171/foc.1998.4.5.517154451) Brotchi J, Bruneau M, Lefranc F, Baleriaux D (2006) Surgery of intraspinal cord tumors. Clin Neurosurg 53:209–216. (PMID: 17380754) Epstein FJ, Farmer JP, Freed D (1993) Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients. J Neurosurg 79:204–209. https://doi.org/10.3171/jns.1993.79.2.0204. (PMID: 10.3171/jns.1993.79.2.02048331401) Eroes CA, Zausinger S, Kreth FW, Goldbrunner R, Tonn JC (2010) Intramedullary low grade astrocytoma and ependymoma. Surgical results and predicting factors for clinical outcome. Acta Neurochir (Wien) 152:611–618. https://doi.org/10.1007/s00701-009-0577-x. (PMID: 10.1007/s00701-009-0577-x) Klekamp J (2015) Spinal ependymomas. Part 1: intramedullary ependymomas. Neurosurg Focus 39:E6. https://doi.org/10.3171/2015.5.FOCUS15161. (PMID: 10.3171/2015.5.FOCUS1516126235023) Kopelson G, Linggood RM, Kleinman GM, Doucette J, Wang CC (1980) Management of intramedullary spinal cord tumors. Radiology 135:473–479. https://doi.org/10.1148/radiology.135.2.7367644. (PMID: 10.1148/radiology.135.2.73676447367644) Kutty RK, Ohmori K, Yamada Y, Kato Y (2020) Cervicomedullary ependymoma with hemorrhage: a case report and review of literature. Asian J Neurosurg 15:190–193. https://doi.org/10.4103/ajns.AJNS_233_19. (PMID: 10.4103/ajns.AJNS_233_19321812017057875) Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1. (PMID: 10.1007/s00401-016-1545-12715793127157931) McCormick PC, Stein BM (1990) Intramedullary tumors in adults. Neurosurg Clin N Am 1:609–630. (PMID: 10.1016/S1042-3680(18)30793-9) McCormick PC, Torres R, Post KD, Stein BM (1990) Intramedullary ependymoma of the spinal cord. J Neurosurg 72:523–532. https://doi.org/10.3171/jns.1990.72.4.0523. (PMID: 10.3171/jns.1990.72.4.05232319309) Peker S, Ozgen S, Ozek MM, Pamir MN (2004) Surgical treatment of intramedullary spinal cord ependymomas: can outcome be predicted by tumor parameters? J Spinal Disord Tech 17:516–521. https://doi.org/10.1097/01.bsd.0000129585.91599.5c. (PMID: 10.1097/01.bsd.0000129585.91599.5c15570124) Prokopienko M, Kunert P, Podgorska A, Marchel A (2017) Surgical treatment of intramedullary ependymomas. Neurol Neurochir Pol 51:439–445. https://doi.org/10.1016/j.pjnns.2017.06.008. (PMID: 10.1016/j.pjnns.2017.06.00828826916) Sun XY, Wang W, Zhang TT, Kong C, Sun SY, Guo MC, Ding JZ, Lu SB (2019) Factors associated with postoperative outcomes in patients with intramedullary Grade II ependymomas: a systematic review and meta-analysis. Medicine (Baltimore) 98:e16185. https://doi.org/10.1097/MD.0000000000016185. (PMID: 10.1097/MD.0000000000016185) Svoboda N, Bradac O, de Lacy P, Benes V (2018) Intramedullary ependymoma: long-term outcome after surgery. Acta Neurochir (Wien) 160:439–447. https://doi.org/10.1007/s00701-017-3430-7. (PMID: 10.1007/s00701-017-3430-7) Symonds CP, Meadows SP, Julian T (1937) Compression of the spinal cord in the neighbourhood of the foramen magnum: with a note on the surgical approach. Brain 60:52–84. https://doi.org/10.1093/brain/60.1.52%JBrain. Tsutsumi S, Higo T, Kondo A, Abe Y, Yasumoto Y, Ito M (2007) Atypical cervical astrocytoma manifesting as occipitalgia. Neurol Med Chir (Tokyo) 47:371–374. https://doi.org/10.2176/nmc.47.371. (PMID: 10.2176/nmc.47.371) Wang X, Gao J, Wang T, Li Z, Li Y (2018) The long-term outcome after resection of upper cervical spinal cord tumors: report of 51 consecutive cases. Sci Rep 8:14831. https://doi.org/10.1038/s41598-018-33263-8. (PMID: 10.1038/s41598-018-33263-8302879416172239) Watanabe M, Sakai D, Yamamoto Y, Iwashina T, Sato M, Mochida J (2009) Upper cervical spinal cord tumors: review of 13 cases. J Orthop Sci 14:175–181. https://doi.org/10.1007/s00776-008-1309-4. (PMID: 10.1007/s00776-008-1309-419337809) Whitaker SJ, Bessell EM, Ashley SE, Bloom HJ, Bell BA, Brada M (1991) Postoperative radiotherapy in the management of spinal cord ependymoma. J Neurosurg 74:720–728. https://doi.org/10.3171/jns.1991.74.5.0720. (PMID: 10.3171/jns.1991.74.5.07202013772) Wostrack M, Ringel F, Eicker SO, Jagersberg M, Schaller K, Kerschbaumer J, Thome C, Shiban E, Stoffel M, Friedrich B, Kehl V, Vajkoczy P, Meyer B, Onken J (2018) Spinal ependymoma in adults: a multicenter investigation of surgical outcome and progression-free survival. J Neurosurg Spine 28:654–662. https://doi.org/10.3171/2017.9.SPINE17494. (PMID: 10.3171/2017.9.SPINE1749429521579) Yang C, Li G, Fang J, Wu L, Yang T, Deng X, Xu Y (2014) Intramedullary gangliogliomas: clinical features, surgical outcomes, and neuropathic scoliosis. J Neurooncol 116:135–143. https://doi.org/10.1007/s11060-013-1267-3. (PMID: 10.1007/s11060-013-1267-324132615) Yasuoka S, Okazaki H, Daube JR, MacCarty CS (1978) Foramen magnum tumors. Analysis of 57 cases of benign extramedullary tumors. J Neurosurg 49:828–838. https://doi.org/10.3171/jns.1978.49.6.0828. (PMID: 10.3171/jns.1978.49.6.0828731299)
فهرسة مساهمة:	Keywords: Ependymoma; Intramedullary tumor; Prognosis; Surgical resection; Upper cervical spinal cord
تواريخ الأحداث:	Date Created: 20200809 Date Completed: 20210629 Latest Revision: 20210629
رمز التحديث:	20231215
DOI:	10.1007/s10143-020-01363-7
PMID:	32767042
قاعدة البيانات:	MEDLINE

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تدمد:	1437-2320
DOI:	10.1007/s10143-020-01363-7