Pediatric intramedullary spinal cord tumors: A single center experience

Kutluk, Tezer; Varan, Ali; Kafalı, Candaş; Hayran, Mutlu; Söylemezoğlu, Figen; Zorlu, Faruk; Aydın, Burça; Yalçın, Bilgehan; Akyüz, Canan; Büyükpamukçu, Münevver

doi:10.1016/j.ejpn.2014.09.007

Cited by 33 publications

(20 citation statements)

References 33 publications

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“…LGGs in the cerebellum account for 15–25% of central nervous system (CNS) tumors. Hemispheric, midline structure, optic pathway, spinal cord, and brainstem LGGs also account for a considerable number of CNS tumors . Children with LGG may experience long‐term neurologic impairments, including ataxia, visual impairment, eye movement disorders, hemiplegia, seizures, hearing loss, cranial nerve deficits, and cognitive dysfunction .…”

Section: Introductionmentioning

confidence: 99%

Neurologic impairments from pediatric low‐grade glioma by tumor location and timing of diagnosis

Sadighi

Curtis

Zabrowksi

et al. 2018

Pediatric Blood & Cancer

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Section: Introductionmentioning

confidence: 99%

Neurologic impairments from pediatric low‐grade glioma by tumor location and timing of diagnosis

Sadighi

Curtis

Zabrowksi

et al. 2018

Pediatric Blood & Cancer

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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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“…The use of both intraoperative neurophysiologic monitoring (p ¼ 0.05) and advanced MRI sequences (p ¼ 0.03) guaranteed a better outcome (late KPS) and OS, associated often with a more radical resection. 32 KPS and MC scores underlined a predictive value on OS and PFS: 94% of patients alive at the end of follow-up had late KPS > 70 points (p ¼ 0.0049), whereas only 43% of cases with lower PFS had late KPS > 70 points (progression of disease).…”

Section: Discussionmentioning

confidence: 99%

Outcome Features Analysis in Intramedullary Tumors of the Cervicomedullary Junction: A Surgical Series

Tariciotti

Brunetto

Landi

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Object The aim of this study is to investigate the impact of surgery for different cervicomedullary lesions on symptomatic pattern expression and postoperative outcome. We focused on specific outcome features of the early and late postoperative assessments. The former relies on surgery-related transient and permanent morbidity and feasibility of radicality in eloquent areas, whereas the latter on long-term course in lower grade tumors and benign tumorlike lesions (cavernomas, etc.). Material and Methods We retrospectively analyzed 28 cases of intramedullary tumors of the cervicomedullary junction surgically treated at our institution between 1990 and 2018. All cases were stratified for gender, histology, macroscopic appearance, location, surgical approach, and presence of a plane of dissection (POD). Mean follow-up was 5.6 years and it was performed via periodic magnetic resonance imaging (MRI) and functional assessments (Karnofsky Performance Scale [KPS] and modified McCormick [MC] grading system). Results In all, 78.5% were low-grade tumors (or benign lesions) and 21.5% were high-grade tumors. Sixty-one percent underwent median suboccipital approach, 18% a posterolateral approach, and 21% a posterior cervical approach. Gross total resection was achieved in 54% of cases, near-total resection (>90%) in 14%, and subtotal resection (50–90%) in 32% of cases. Early postoperative morbidity was 25%, but late functional evaluation in 79% of the patients showed KPS > 70 and MC grade I; only 21% of cases showed KPS < 70 and MC grades II and III at late follow-up. Mean overall survival was 7 years in low-grade tumors or cavernomas and 11.7 months in high-grade tumors. Progression-free survival at the end of follow-up was 71% (evaluated mainly on low-grade tumors). Conclusions The surgical goal should be to achieve maximal cytoreduction and minimal postoperative neurologic damage. Functional outcome is influenced by the presence of a POD, radicality, histology, preoperative status, and employment of advanced neuroimaging planning and intraoperative monitoring.

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Pediatric intramedullary spinal cord tumors: A single center experience

Cited by 33 publications

References 33 publications

Neurologic impairments from pediatric low‐grade glioma by tumor location and timing of diagnosis

Neurologic impairments from pediatric low‐grade glioma by tumor location and timing of diagnosis

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

Outcome Features Analysis in Intramedullary Tumors of the Cervicomedullary Junction: A Surgical Series

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