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Myxopapillary ependymoma: correlation of clinical and imaging features with surgical resectability in a series with long-term follow-up.
- Source :
- Spinal Cord; Oct2011, Vol. 49 Issue 10, p1073-1078, 6p, 1 Black and White Photograph, 2 Charts, 2 Graphs
- Publication Year :
- 2011
-
Abstract
- Study design:Retrospective case series.Objectives:The objective of this study is to identify imaging and intraoperative characteristics that may predict surgical resection for myxopapillary ependymoma (MPE). The diffuse involvement in the conus-filum region makes complete resection challenging. The preoperative characteristics that may estimate the extent of resection has not been reported.Setting:Toronto, Canada.Methods:All MPE cases between 1972 and 2005 at a single institution were identified and reexamined by a neuropathologist. Neurological outcomes (Frankel scale), clinical features, operative findings, pre and postoperative imaging results were reviewed.Results:A total of 18 operations were performed on 15 MPE patients (8 females/7 males; age range: 18-71 years). Median postoperative follow-up was 56 months. Three patients (17%) developed tumor regrowth requiring reoperations. Preoperative magnetic resonance imaging (MRI; in 14/18 procedures) determined that tumors involved the conus in 70% of cases, which was significantly associated with intraoperative findings (P=0.02). Complete microsurgical resection was accomplished in 4 out of 7 cases where conus was not involved, but in only 1 out of 10 cases with conus involvement (P=0.056). The degree of conus involvement in one case was unclear. None of patients with total surgical resection developed recurrence. All patients survived at long-term follow-up.Conclusion:Our series is the first to correlate MPE involvement to conus medullaris on preoperative MRI with intraoperative findings, and examine its significance on surgical resectability. This information could guide clinicians in preoperative planning and advising patients on treatment options and potential risks/benefits. MRI is very sensitive (100%) and moderately specific (67%) in detecting direct anatomical contact between conus and MPE tumors. [ABSTRACT FROM AUTHOR]
- Subjects :
- GLIOMA treatment
CANCER relapse
CONFIDENCE intervals
STATISTICAL correlation
EPIDEMIOLOGY
FISHER exact test
GLIOMAS
LONGITUDINAL method
MAGNETIC resonance imaging
HEALTH outcome assessment
PREOPERATIVE care
SPINAL cord
SURGICAL complications
SURVIVAL analysis (Biometry)
SURGICAL therapeutics
DECISION making in clinical medicine
DATA analysis
TREATMENT effectiveness
RETROSPECTIVE studies
DISEASE progression
DATA analysis software
DIAGNOSIS
ANATOMY
Subjects
Details
- Language :
- English
- ISSN :
- 13624393
- Volume :
- 49
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Spinal Cord
- Publication Type :
- Academic Journal
- Accession number :
- 66357607
- Full Text :
- https://doi.org/10.1038/sc.2011.67