Intramedullary ependymoma: long-term outcome after surgery

Svoboda, Norbert; Bradáč, Ondřej; Lacy, Patricia de; Beneš, Vladimı́r

doi:10.1007/s00701-017-3430-7

Cited by 29 publications

(26 citation statements)

References 54 publications

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“…Thirty-nine studies met our inclusion criteria (sample sizes ranged from 10 to 221 patients; the total number of participants across studies was 1191). 7 , 14 - 50 , 56 All the included studies were case series. The description of the studies is presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Complete Versus Incomplete Surgical Resection in Intramedullary Ependymomas: A Systematic Review and Meta-analysis

Salari

Golpayegani

Sadeghi‐Naini

et al. 2020

Global Spine Journal

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Study Design: Systematic review. Objective: To compare outcomes of complete versus incomplete resection in primary intramedullary spinal cord ependymoma. Methods: A comprehensive search of the MEDLINE, CENTRAL, and Embase databases was conducted by 2 independent investigators. Random-effect meta-analysis and meta-regression with seven covariates were performed to evaluate the reason for the heterogeneity among studies. We also used individual patient data in the integrative analysis to compare complete and incomplete resection based on 4 outcomes: progression-free survival (PFS), overall survival (OS), postoperative neurological improvement (PNI), and follow-up neurological improvement (FNI). Results: A total of 23 studies were identified, including 407 cases. Significant heterogeneity among included studies was observed in risk estimates (I2 for PFS, FNI, and PNI were 49.5%, 78.3%, and 87.2%, respectively). The mean follow-up time across cases was 48.6 ± 2.35 months. Cox proportional multivariable analysis revealed that the complete resection can prolong PFS (model, hazard ratio = 0.18, CI 0.05-0.54, P = .004,) and improve the FNI (binary logistic regression, adjusted odds ratio = 16.5, CI 1.6-171, P = .019). However, PNI and OS were similar in patients with incomplete resected spinal cord ependymoma compared with complete resection (binary logistic regression respectively and Cox multivariable analysis, P > .5). Conclusion: The data presented in this study showed that OS was not significantly affected by the degree of surgery. However, complete resection of intramedullary ependymomas provides the optimal outcomes with longer PFS and better long-term neurological outcomes than incomplete resection.

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Section: Resultsmentioning

confidence: 99%

Complete Versus Incomplete Surgical Resection in Intramedullary Ependymomas: A Systematic Review and Meta-analysis

Salari

Golpayegani

Sadeghi‐Naini

et al. 2020

Global Spine Journal

View full text Add to dashboard Cite

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“…Although numerous studies have discussed the predictors of surgical outcomes in patients with spinal ependymomas, the majority of existing evidence focuses on tumor recurrence and overall survival [18,15,[22][23][24], and investigations concerning neurological functions remain limited [5,19,24]. In 2011, Boström and colleagues retrospectively analyzed functional outcomes in 57 cases of spinal ependymoma, in which complete resection was gained in 83% of cases.…”

Section: Discussionmentioning

confidence: 99%

Multisegmental versus monosegmental intramedullary spinal cord ependymomas: perioperative neurological functions and surgical outcomes

et al. 2021

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Objectives: Multiple factors, such as tumor size, lateralization, tumor location, accompanying syringomyelia, and regional spinal cord atrophy, may affect the resectability and clinical prognosis of intramedullary spinal cord ependymomas. However, whether longsegmental involvement of the spinal cord may impair functional outcomes remains unclear. This study was aimed to compare perioperative neurological functions and long-term surgical outcomes between multisegmental ependymomas and their monosegmental counterparts.Methods: A total of 54 patients with intramedullary spinal cord ependymoma (WHO Grade II) were enrolled, and all of them underwent surgical resection. The patients were classi ed into the multisegmental group (n=40) and the monosegmental group (n=14). Perioperative and long-term (average follow-up period, 53.5 ± 18.2 months) neurological functions were evaluated using the modi ed McCormick (mMC) scale and the modi ed Japanese Orthopaedic Association (mJOA) scoring system.Results: Preoperative neurological functions in the multisegmental group were signi cantly worse than those in the monosegmental group (P < 0.05). However, postoperative short-term neurological functions, as well as long-term functional outcomes, were similar between the two groups (P > 0.05). Logistic regression analysis showed that only preoperative mMC and mJOA scores were signi cantly correlated with neurological improvement during the follow-up period (P < 0.05). Conclusion:Multisegmental involvement of the spinal cord is associated with worse neurological functions in patients with intramedullary spinal cord ependymoma, while the long-term prognosis is not affected. The preoperative neurological status of the patient is the only predictor of long-term functional improvement.

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“…The reported prognostic factors of ependymoma include age, tumor location, histological grade, the extent of resection (EOR), metastatic spread, Ki-67 status, and adjuvant radiotherapy (Metellus et al 2007;Kuncova et al 2009;Merchant et al 2009;Pejavar et al 2011;Tarapore et al 2013;Sayegh et al 2014). EOR is the most essential prognostic factor for ependymoma (Venkatramani et al 2013;Lin and Chintagumpala 2015;Ye et al 2015;Ramaswamy and Taylor 2016;Sato et al 2017;Jung et al 2018;Svoboda et al 2018). The Ki-67 protein is a biomarker for Liguo Wang and Song Han contributed equally to this work.…”

Section: Introductionmentioning

confidence: 99%

The role of clinical factors and immunocheckpoint molecules in the prognosis of patients with supratentorial extraventricular ependymoma: a single-center retrospective study

Wang

Han

Chen

et al. 2021

J Cancer Res Clin Oncol

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Purpose Supratentorial extraventricular ependymoma (SEE) is a rare subset of ependymomas located in the supratentorial parenchyma, and little is known regarding its management and prognosis. Our study aimed to reveal the prognostic factors in patients with SEE and the roles of programmed death ligand-1 (PD-L1), programmed cell death protein 1 (PD-1), Ki-67, and neural cell adhesion molecule L1 (L1CAM) in predicting these patients’ outcomes. Methods We retrospectively studied the clinical features and prognostic factors in 48 patients with SEE admitted to our center from April 2008 to October 2018. Tissue slides were constructed from patient samples, and PD-L1, PD-1, Ki-67, and L1CAM expression levels were evaluated by immunohistochemistry. Results Patients with gross total resection (GTR) had better progression-free survival than patients with subtotal resection (STR). Moreover, the recurrence hazard ratios in patients with STR at 3, 5, and 10 years were 8.746, 6.866 and 3.962 times those of patients with GTR, respectively. PD-L1 positivity predicted worse progression-free survival, while the recurrence hazard ratios for patients with PD-L1 positivity at 3, 5, and 10 years were 10.445, 5.539, and 3.949 times those of patients with PD-L1 negativity, respectively. Multivariate analysis revealed that PD-L1 expression and GTR could independently predict outcomes in patients with SEE. Conclusion PD-L1 expression was an independent and more readily obtained predictor of outcomes, representing a simple and reliable biological prognostic factor for patients with SEE. Further studies are needed to explore PD-L1 inhibitor treatment for patients with ependymoma. Clinical trial registration No clinical trials were performed in the study.

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Intramedullary ependymoma: long-term outcome after surgery

Cited by 29 publications

References 54 publications

Complete Versus Incomplete Surgical Resection in Intramedullary Ependymomas: A Systematic Review and Meta-analysis

Complete Versus Incomplete Surgical Resection in Intramedullary Ependymomas: A Systematic Review and Meta-analysis

Multisegmental versus monosegmental intramedullary spinal cord ependymomas: perioperative neurological functions and surgical outcomes

The role of clinical factors and immunocheckpoint molecules in the prognosis of patients with supratentorial extraventricular ependymoma: a single-center retrospective study

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