Clinical management and prognosis of spinal myxopapillary ependymoma: a single-institution cohort of 72 patients

Zhang, Yao-Wu; Wang, Bo; An, Song-Yuan; Liu, Weihao; Wang, Chong; Yan, Hao; Xu, Yulun; Wang, Yongzhi; Jia, Wenqing

doi:10.1007/s00586-023-07690-9

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…As such, evidence to guide optimal treatment strategies has been mixed and prone to institutional bias. Primary surgical management is universally described as the backbone of therapy and has been shown to consistently and profoundly improve outcomes [ 13 , 24 , 25 , 26 , 27 , 28 ]. Our data support this notion, as receipt of surgery was associated with improved OS even when accounting for other covariates in a multivariable model.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

Wang,

Rooney,

Alvarez-Breckenridge

et al. 2024

Cancers

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(1) Background: Myxopapillary ependymoma (MPE) is a rare tumor of the spine, typically slow-growing and low-grade. Optimal management strategies remain unclear due to limited evidence given the low incidence of the disease. (2) Methods: We analyzed data from 1197 patients with spinal MPE from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2020). Patient demographics, treatment modalities, and survival outcomes were examined using statistical analyses. (3) Results: Most patients were White (89.9%) with a median age at diagnosis of 42 years. Surgical resection was performed in 95% of cases. The estimated 10-year overall survival was 91.4%. Younger age (hazard ratio (HR) = 1.09, p < 0.001) and receipt of surgery (HR = 0.43, p = 0.007) were associated with improved survival. Surprisingly, male sex was associated with worse survival (HR = 1.86, p = 0.008) and a younger age at diagnosis compared to females. (4) Conclusions: This study, the largest of its kind, underscores the importance of surgical resection in managing spinal MPE. The unexpected association between male sex and worse survival warrants further investigation into potential sex-specific pathophysiological factors influencing prognosis. Despite limitations, our findings contribute valuable insights for guiding clinical management strategies for spinal MPE.

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Section: Discussionmentioning

confidence: 99%

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

Wang,

Rooney,

Alvarez-Breckenridge

et al. 2024

Cancers

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“…Appropriate surgical techniques for tumor removal are essential to treat MPEs, as they play a crucial role in determining outcomes 7 . Incomplete resection of the tumor and disruption of the tumor capsule are unfavorable prognostic markers, as they are associated with an increased likelihood of tumor recurrence and postoperative neurologic deficit 4 , 6 , 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

Development of a novel prediction model for differential diagnosis between spinal myxopapillary ependymoma and schwannoma

Song,

Kim,

Lee

et al. 2024

Sci Rep

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Spinal myxopapillary ependymoma (MPE) and schwannoma represent clinically distinct intradural extramedullary tumors, albeit with shared and overlapping magnetic resonance imaging (MRI) characteristics. We aimed to identify significant MRI features that can differentiate between MPE and schwannoma and develop a novel prediction model using these features. In this study, 77 patients with MPE (n = 24) or schwannoma (n = 53) who underwent preoperative MRI and surgical removal between January 2012 and December 2022 were included. MRI features, including intratumoral T2 dark signals, subarachnoid hemorrhage (SAH), leptomeningeal seeding, and enhancement patterns, were analyzed. Logistic regression analysis was conducted to distinguish between MPE and schwannomas based on MRI parameters, and a prediction model was developed using significant MRI parameters. The model was validated internally using a stratified tenfold cross-validation. The area under the curve (AUC) was calculated based on the receiver operating characteristic curve analysis. MPEs had a significantly larger mean size (p = 0.0035), higher frequency of intratumoral T2 dark signals (p = 0.0021), associated SAH (p = 0.0377), and leptomeningeal seeding (p = 0.0377). Focal and diffuse heterogeneous enhancement patterns were significantly more common in MPEs (p = 0.0049 and 0.0038, respectively). Multivariable analyses showed that intratumoral T2 dark signal (p = 0.0439) and focal (p = 0.0029) and diffuse enhancement patterns (p = 0.0398) were independent factors. The prediction model showed an AUC of 0.9204 (95% CI 0.8532–0.9876) and the average AUC for internal validation was 0.9210 (95% CI 0.9160–0.9270). MRI provides useful data for differentiating spinal MPEs from schwannomas. The prediction model developed based on the MRI features demonstrated excellent discriminatory performance.

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Specifics of spinal neuropathology in the molecular age

Kresbach,

Hack,

Ricklefs

et al. 2024

Neuro-Oncology Advances

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Tumors located in the spinal cord and its coverings can be diagnostically challenging and require special consideration regarding treatment options. During the last decade, important advances regarding the molecular characterization of central and peripheral nervous system tumors were achieved, resulting in improved diagnostic precision, and understanding of the tumor spectrum of this compartment. In particular, array-based global DNA methylation profiling has emerged as a valuable tool to delineate biologically and clinically relevant tumor subgroups and has been incorporated in the current WHO classification for central nervous system tumors of 2021. In addition, several genetic drivers have been described, which may also help to define distinct tumor types and subtypes. Importantly, the current molecular understanding not only sharpens diagnostic precision but also provides the opportunity to investigate both targeted therapies as well as risk-adapted changes of treatment intensity. Here, we discuss the current knowledge and the clinical relevance of molecular neuropathology in spinal tumor entities.

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Clinical management and prognosis of spinal myxopapillary ependymoma: a single-institution cohort of 72 patients

Cited by 5 publications

References 29 publications

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

Development of a novel prediction model for differential diagnosis between spinal myxopapillary ependymoma and schwannoma

Specifics of spinal neuropathology in the molecular age

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