Clinical characteristics and long-term surgical outcome of spinal myxopapillary ependymoma: a French cohort of 101 patients

Abstract

Purpose

Myxopapillary ependymoma (MPE) is the most frequent tumor affecting the medullary conus. The surgical therapeutic management is still debated and only few studies have focused on the postoperative clinical outcome of patients. This study aimed to demonstrate long-term postoperative outcome and to assess the predictive factors of recurrence as well as the clinical evolution of these patients.

Methods

From 1984 to 2019, in four French centers, 101 adult patients diagnosed with MPE were retrospectively included.

Results

Median age at surgery was 39 years. Median tumor size was 50 mm and lesions were multifocal in 13% of patients. All patients benefited from surgery and one patient received postoperative radiotherapy. Gross total resection was obtained in 75% of cases. Sixteen percent of patients presented recurrence after a median follow-up of 70 months. Progression free survival at 5 and 10 years were respectively estimated at 83% and 79%. After multivariable analysis, sacral localization, and subtotal resection were shown to be independently associated with tumor recurrence. 85% of the patients had a favorable evolution concerning pain. 12% of the patients presented a postoperative deterioration of sphincter function and 4% of motor function.

Conclusion

Surgery alone is an acceptable option for MPE patients. Patients with sacral location or incomplete resection are at high risk of recurrence and should be carefully monitored.

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Data availability

Anonymized data will be shared on request from any qualified investigator.

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Authors

Contributions

A.S.M and B.M. Conceptualization; A.S.M and B.M. methodology; all the authors. validation; A.S.M., F.Be. and B.M. formal analysis; A.S.M., S.T., G.L., S.G., M.P., C.A., F.P., A.I., L.F., F.Bi and B.M. investigation; B.M. resources; A.S.M., S.T., G.L., S.G., M.P., C.A., F.P., A.I., L.F., F.Bi and B.M. data curation; A.S.M., A.A. and B.M. writing—original draft preparation; all the authors writing—review and editing; B.M. and A.C. supervision. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Bertrand Mathon.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The protocol can be found in the reference methodology MR003 chapter adopted by the Commission Nationale de l’Informatique et des Libertés (No 2219024 v0) in agreement with the policies of the University Hospitals involved in this project.

Consent to participate

In accordance with the ethical standards of our hospital’s institutional review board, the Committee for the Protection of Human Subjects, and French law, written informed consent was not needed for demographic, physiological and hospital-outcome data analyses because this observational study did not modify existing diagnostic or therapeutic strategies; however, patients were informed of their inclusion in the study.

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Montero, AS., Tran, S., Amelot, A. et al. Clinical characteristics and long-term surgical outcome of spinal myxopapillary ependymoma: a French cohort of 101 patients. J Neurooncol (2021). https://doi.org/10.1007/s11060-021-03717-7

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Keywords

  • Spinal tumor
  • Spine
  • Extramedullary tumor
  • Molecular biology
  • Radiation therapy
  • Recurrence