Epidemiology of Surgically Treated Primary Spinal Cord Tumors in Miyagi, Japan

Ozawa, Hiroshi; Aizawa, Tadanori; Kanno, Haruo; Sano, Hirotaka; Itoi, Eiji

doi:10.1159/000353561

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…Of note, the overall incidence of spinal schwannomas appears to be greater in Japan than in Western countries. 18,19 Similarly to other surgical series, in our study the lumbar spine was the most common segment in which conventional schwannomas were found. In addition, the majority of our patients' tumors were intradural-extramedullary which is consistent with all other comparable surgical series.…”

Section: Discussionsupporting

confidence: 82%

Risk Factors for Recurrence of Surgically Treated Conventional Spinal Schwannomas

Fehlings

Nater

Zamorano

et al. 2016

SPINE

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Study Design Retrospective analysis of 169 adult patients operated for a conventional spinal schwannoma from the AOSpine Multicenter Primary Spinal Tumors Database. Objective To identify risk factors for local recurrence of conventional spinal schwannoma in patients who had surgery. Summary of Background Data Schwannomas account for up to 30% of all adult spinal tumors. Total resection is the gold standard for patients with sensory or motor deficits. Local recurrence is reported to be approximately 5% and usually occurs several years after surgery. Methods Rates and time of local recurrence of spinal schwannoma were quantified. Predictive value of various clinical factors was assessed, including age, gender, tumor size, affected spinal segment, and type of surgery. Descriptive statistics and univariate regression analyses were performed. Results Nine (5.32%) out the 169 patients in this study experienced local recurrence approximately 1.7 years post-operatively. Univariate analyses revealed that recurrence tended to occur more often in younger patients (39.33 ± 14.58 years versus 47.01 ± 15.29 years) and in the lumbar segment (55.56%), although this did not reach significance (HR=0.96, p = 0.127; and p = 0.195, respectively). Recurrence also arose in the cervical and sacral spine (22.22%, respectively) but not in the thoracic area. Tumors were significantly larger in patients with recurrence (6.97 ± 4.66 cm versus 3.81 ± 3.34 cm), with extent in the cranial-caudal direction posing the greatest hazard (HR=1.321, p = 0.002). The location of the tumor, whether epidural, intradural, or both (p = 0.246) was not significantly related to recurrence. Regarding surgical technique, over four times as many patients who underwent intralesional resection experienced a recurrence proportionally to patients who underwent en bloc resection (HR = 4.178, p = 0.033). Conclusions The pre-operative size of the conventional spinal schwannoma and intralesional resection are the main risk factors for local post-operative recurrence.

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Section: Discussionsupporting

confidence: 82%

Risk Factors for Recurrence of Surgically Treated Conventional Spinal Schwannomas

Fehlings

Nater

Zamorano

et al. 2016

SPINE

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“…8 The incidence of SCHs was reported to be approximately 4-5 times the incidence of meningiomas in Japan. 3,6 In the present study, we suspected that 23 of 24 radiologically observed, solitary, intradural extramedullary tumors were SCHs. The majority of the affected cord levels were in the lumbar region, similar to another report.…”

Section: Discussionmentioning

confidence: 58%

How do spinal schwannomas progress? The natural progression of spinal schwannomas on MRI

Ando¹,

Imagama²,

Ito³

et al. 2016

SPI

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OBJECT Little is known about the progression of spinal schwannomas. The aim of this study was to determine the natural progression of spinal schwannomas and establish the risk of tumor growth. METHODS This study retrospectively analyzed data from 23 patients (12 men and 11 women, 40–89 years old) with schwannomas detected by MRI. The mean follow-up period was 5 years (range 2–10 years). The absolute and relative growth rates of the tumors were calculated. RESULTS The average tumor size was 1495 mm3 at the initial visit and 2224 mm3 at the final follow-up. The average absolute growth rate was 139 mm3 per year, and the average relative growth rate was 5.3% per year. Tumors were classified into 3 groups based on enhancement patterns: isointense/hyperintense (iso/high; 11 cases), rim enhancement when enhancement was peripheral (high/rim; 5 cases), and heterogeneous/heterogeneous (hetero/hetero; 7 cases) based on Gd-enhanced T2-weighted MRI. The average absolute growth rates of the 3 lesion groups were 588 mm3, 957 mm3, and 3379 mm3, respectively (p < 0.01). CONCLUSIONS Although the tumors classified as iso/high and high/rim on T2-weighted Gd-enhanced MR images were small and grew very little, most tumors with hetero/hetero classification increased in size. Hetero/hetero-type tumors should be followed closely and may require surgery.

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“…Among other case series that included patients with primary spinal cord tumors, both intramedullary and extramedullary, the most frequent histological type in Asian studies was schwannoma. This proportion seems to be especially increased in the Japanese population, where schwannomas account for 56% and 57.2% of the lesions [ 7 , 19 ]. This trend seems to be repeated in the Latin American population, being the most frequent histological type in a Mexican series [ 10 ] and in our sample.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiological indicators, such as the incidence and prevalence of these lesions, seem to vary in geographically and ethnically different populations [ 6 ], and most studies have been conducted in the USA, Europe, and Asia [ 7 ]. There are few articles regarding the epidemiology of these lesions in Latin American populations.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Surgically Treated Primary Spinal Cord Tumors in a Single Brazilian Institution: A Case Series Study of 104 Patients

Júnior¹,

Dantas²,

Caires³

et al. 2022

Cureus

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Background: Primary spinal cord tumors are rare and heterogeneous, and their prevalence varies among the studies. Few articles have evaluated the prevalence, characteristics, and histological types of spinal cord tumors in Latin American populations. This study aimed to analyze the histological types and clinical aspects of a series of consecutive patients diagnosed with primary spinal cord tumors who underwent surgical treatment in a single Brazilian institution and to compare them with the literature. Methods: This is a case series study, with retrospective analysis of all consecutive adult patients who underwent surgical treatment for primary spinal cord tumors in a single center between January 1997 and April 2021. Data analyzed included age at surgery, sex, anatomical location, histopathological diagnosis, clinical presentation, and neurological status at discharge. Results: A total of 104 patients (53 women [51.0%]; mean age, 49.0 ± 16.7 years [range, 19-87 years]) were included in the analysis. Among the tumors, 83.7% were benign, and 36.5% involved the thoracic spine; intradural extramedullary lesions comprised 52.9% of the tumors, and the most prevalent were schwannomas (26.9%) and meningiomas (18.3%). Among the patients, 55% and 50% presented with pain and motor deficit, respectively, and the deficit improvement rate was greater than the worsening rate at the immediate postoperative period and discharge. Conclusions: Our series highlights the heterogeneity of primary spinal cord tumors compared to other studies. Further large population studies are necessary to elucidate the epidemiology of this disease.

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Epidemiology of Surgically Treated Primary Spinal Cord Tumors in Miyagi, Japan

Cited by 10 publications

References 12 publications

Risk Factors for Recurrence of Surgically Treated Conventional Spinal Schwannomas

Risk Factors for Recurrence of Surgically Treated Conventional Spinal Schwannomas

How do spinal schwannomas progress? The natural progression of spinal schwannomas on MRI

Evaluation of Surgically Treated Primary Spinal Cord Tumors in a Single Brazilian Institution: A Case Series Study of 104 Patients

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