Document Detail

Intramedullary low grade astrocytoma and ependymoma. Surgical results and predicting factors for clinical outcome.
MedLine Citation:
PMID:  20119838     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The optimal time point for surgery of intramedullary spinal astrocytomas and ependymomas is often debated on, as predicting factors are poorly defined. The current single-institutional study was conducted to retrospectively analyze prognostic factors for postoperative functional outcome in these patients. MATERIAL AND METHODS: All consecutive adult patients with intramedullary astrocytomas or ependymomas (except filum terminale ependymomas) were included. Imaging data, McCormick score (MCS), and detailed neurological evaluation were stringently applied preoperatively, 1 week, and 6 months postoperatively for functional evaluation of all patients. End points were early and late functional outcome. Prognostic factors were obtained from univariate and multivariate logistic regression analysis. RESULTS: Forty-four patients were included (29 ependymomas World Health Organization (WHO) grades I or II, 8 astrocytomas WHO grade I, and 7 astrocytomas WHO grade II). Overall perioperative morbidity was 34%, and there was no mortality. Complete tumor resection was achieved in 79% of ependymomas, 50% of astrocytomas WHO grade I, and 14% of astrocytomas WHO grade II (significantly more often in ependymomas than in astrocytomas, p < 0.05). Early and late functional outcome were highly intercorrelated (p < 0.01), but not correlated to histology. Preoperative MCS <3 and extent of tumor <5 levels were significantly (p = 0.01 and p < 0.05) associated with a favorable outcome (MCS <3) in early and late follow-up. CONCLUSION: An MCS of less than 3 and a tumor extent of less than 5 levels are the most important factors for a favorable postoperative functional outcome. Therefore, surgery should be initiated before significant clinical symptomatology or substantial tumor growth occurs.
Christian A Eroes; Stefan Zausinger; Friedrich-Wilhelm Kreth; Roland Goldbrunner; Joerg-Christian Tonn
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Publication Detail:
Type:  Journal Article     Date:  2010-02-01
Journal Detail:
Title:  Acta neurochirurgica     Volume:  152     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-24     Completed Date:  2010-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  611-8     Citation Subset:  IM    
Neurosurgical Department, University Clinic Munich, Klinikum Grosshadern, 81377 Munich, Germany.
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MeSH Terms
Astrocytoma / diagnosis,  drug therapy,  radiotherapy,  surgery*
Chemotherapy, Adjuvant
Combined Modality Therapy
Ependymoma / diagnosis,  drug therapy,  radiotherapy,  surgery*
Follow-Up Studies
Magnetic Resonance Imaging
Middle Aged
Neurologic Examination
Radiotherapy, Adjuvant
Retrospective Studies
Spinal Cord Neoplasms / diagnosis,  drug therapy,  radiotherapy,  surgery*
Ultrasonography, Interventional

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