[Intramedullary astrocytoma and ependymoma in the adult. Do therapeutic tactics influence the long-term results? Evaluation of 23 surgically treated cases and discussion of the literature]

The authors tried to determine the best treatment of intramedullary tumors nowadays. They studied a personal series of 23 intraspinal ependymomas and astrocytomas. 15 patients had a mean long term follow-up of 5 1/2 years. Among these, only patients with ependymomas were clinically cured or dramatically improved (30%). On the contrary, no patients operated on an astrocytoma received benefit of the surgical procedure. This study was compared to most of the recent series of the literature , the results of which are superimposable . Concerning an intraspinal ependymoma, a logical attitude is to proceed, under optic magnification, to the most complete excision as possible, as long as a well individualized plan of cleavage is visible. Radiotherapy is indicated only in case of incomplete excision or recidive. Concerning an astrocytoma, a total excision is almost always impossible since it is an infiltrating tumor. It appears more dangerous than advantageous to try to take off as much tumor as possible. Radiotherapy appears inefficient.