Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina

Abstract

OBJECT Patients having a primary tumor of the spinal cord, spinal meninges or cauda equina, are relatively rare. Neurosurgeons encounter and treat such patients, and need to be aware of their clinical presentation, tumor types, treatment options, and potential complications. The purpose of this paper is to report results from a series of 430 patients with primary intraspinal tumors, taken from a larger cohort of 9661 patients with primary tumors of the CNS. METHODS Extensive information on individuals diagnosed (in the year 2000) as having a primary CNS neoplasm was prospectively collected in a Patient Care Evaluation Study conducted by the Commission on Cancer of the American College of Surgeons. Data from US hospital cancer registries were submitted directly to the National Cancer Database. Intraspinal tumor cases were identified based on ICD-O-2 topography codes C70.1, C72.0, and C72.1. Analyses were performed using SPSS. RESULTS Patients with primary intraspinal tumors represented 4.5% of the CNS tumor group, and had a mean age of 49.3 years. Pain was the most common presenting symptom, while the most common tumor types were meningioma (24.4%), ependymoma (23.7%), and schwannoma (21.2%). Resection, surgical biopsy, or both were performed in 89.3% of cases. Complications were low, but included neurological worsening (2.2%) and infection (1.6%). Radiation therapy and chemotherapy were administered to 20.3% and 5.6% of patients, respectively. CONCLUSIONS Data from this study are suitable for benchmarking, describing prevailing patterns of care, and generating additional hypotheses for future studies.

Primary spinal cord tumors: review of 678 surgically treated patients in Japan. A multicenter study

“…This tendency is even stronger in eastern Asia [2,[11][12][13]15]. On the other hand, the incidence of meningiomas in non-Asian countries (USA, Europe, Australia), is equal to or higher than that of NSCTs [8,10,16,17,21] with the exception of only one report [18]. In the series from Germany [18], authors counted multiple tumors in one patient (probably, neurofibromatosis or schwannomatosis).…”

“…Our results confirm previous reports [2,[13][14][15] which demonstrate different frequencies of NSCTs, meningiomas, and neuroepithelial tumors between Asian countries and other parts of the world. According to previous studies [10,13,[15][16][17]21], the male/female ratios for patients with primary spinal cord tumors vary among countries from 40 % male/60 % female in the USA [10] to 60.3 % male/39.7 % female in China [13] (Table 5). In our current study in Japan, of 678 primary spinal cord tumors 55.6 % were male and 44.4 % were female.…”

Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004‐2007

“…This study complements a recent study published by Engelhard et al that reported the clinical presentation, histology, and treatment of 430 patients with primary tumors of the spinal cord, spinal meninges, and cauda equina. 4 Together, these studies provide a comprehensive perspective of the epidemiology of primary spinal tumors.…”

“…19 Lastly, a study using the National Cancer Database by Engelhard et al found that the most common tumor types were meningioma (24.4%), ependymoma (23.7%), and schwannoma (21.2%). 4 The overall incidence of spinal tumors (malignant and nonmalignant combined) found in our study (0.97 per 100,000 persons) is lower than that found in France (1.20 per 100,000 persons), 3 Croatia (1.60 per 100,000 persons), 18 or Rochester, Minnesota (2.50 per 100,000 persons), 20 but is higher than that observed in a study by Schellinger et al (0.74 per 100,000 persons) 6 or Estonia (0.80 per 100,000 persons). 5 Sample size and population differences may explain differences found in France, Croatia, Minnesota, and Estonia.…”

“…Primary tumors of the spinal cord, spinal meninges, and cauda equina (subsequently referred to as ''spinal tumors'') are relatively rare, [1][2][3][4][5] and there is a paucity of population-based data available on tumors in these sites. 6 This is due, in large part, to the limited availability of cases ascertained with these tumors at single clinical settings.…”