Management of intramedullary spinal cord tumors.

Kopelson, Gene; Linggood, Rita M.; Kleinman, George; Doucette, John; Wang, C C

doi:10.1148/radiology.135.2.7367644

Cited by 163 publications

(79 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Study periods in all of the papers were different and overlapping, numerous patients had to be included in more than one article. Similar situation came around with University of Rome [20,26,27,57] and Massachusetts General Hospital [37,38]. We were able to ascertain that all patients reported by Abdel-Wahab et al [1] were included in the follow-up enlarged study [2], allowing us to concentrate on the more recent study only (Abdel-Wahab, personal communication).…”

Section: Discussionmentioning

confidence: 66%

Prognostic factors in intramedullary astrocytomas: a literature review

2009

View full text Add to dashboard Cite

Astrocytomas affect a significant portion of patients with intramedullary tumors. These infiltratively growing tumors are treated by a variety of methods-biopsy and decompressive surgery, maximal safe resection, adjuvant oncological therapy. Also, numerous prognostic factors are reported in the literature. Better understanding of factors that influence prognosis may help in treatment planning with the goal of prolonging survival. We have thus undertaken an extensive literature review in order to define factors affecting prognosis. A total of 38 articles were studied. Only tumor grade was consistently reported as the major factor affecting prognosis. The influence of other clinical factors (age, gender, history length, functional status, tumor location or extent, syrinx or cyst presence) can be speculated upon, but cannot be assessed adequately from the available literature. For both low-and high-grade (HG) astrocytomas, maximal safe tumor resection should be the primary treatment objective but is often not feasible in contrast to other intramedullary and spinal neoplasms. Since the biological nature of spinal cord HG glioma is identical to that of the brain, the same treatment algorithm of maximal safe resection followed by concomitant radio-and chemotherapy would be sensible to implement.

show abstract

Section: Discussionmentioning

confidence: 66%

Prognostic factors in intramedullary astrocytomas: a literature review

2009

View full text Add to dashboard Cite

show abstract

“…Important but presently unsettled issues include the impact of the extent of resection on local control and survival 1,5,6 and the significance of postoperative radiation therapy. 7 The purpose of the present study was to obtain useful information to establish decision-making guidelines for the treatment of spinal cord astrocytoma by examining the clinical records of patients treated at Keio University Hospital.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of spinal cord astrocytomas

et al. 2006

View full text Add to dashboard Cite

Study design: Retrospective case series.Objectives: To analyze prognostic factors for patients with spinal cord astrocytomas. Setting: Department of Orthopaedic Surgery, Keio University, Japan. Methods: Seven patients received total excisions (group T), eight underwent partial excisions (group P), and 15 had excisional biopsies (group B). Impacts of the tumor histological grade, the level of the tumor, the types of surgical interventions, and the use of adjuvant radiotherapies on the survival and functional outcomes of 30 patients (18 in low-grade and 12 high-grade malignancy tumors) were analyzed. Results: The survival rate of the low-grade malignancy group was significantly higher than that of the high-grade group. The survival rate of the patients with thoracic astrocytomas was significantly higher than those with cervical astrocytomas. In both the low-and high-grade groups, the survival rates in groups P/T were significantly higher than those in group B. In the low-grade group, five patients, whose preoperative functional statuses were classified as 'fair' or better, remained 'fair' or better after surgery. In the high-grade group, the postoperative functional statuses were classified as 'no change' or 'aggravated' in all except two patients. No significant difference in the survival rates was detected between patients with and without adjuvant radiotherapy. Conclusions: The tumor grade and the extent of tumor resection were significant prognostic factors for survival rate. In low-grade malignancy group, good motor function was retained when surgeries were performed before substantial neurological deterioration. The efficacy of postoperative radiotherapy has yet to be determined and needs further study.

show abstract

“…The treatment strategy for intramedullary spinal cord tumors including spinal ependymomas has been controversial. Some advocate minimal surgery and radical radiation, 18,19 others have reported excellent results with radical resection without radiation. 6 ± 8,16 Many papers have been published concerning radiotherapy as an adjunctive treatment for intramedullary spinal cord tumors.…”

Section: Discussionmentioning

confidence: 99%

Ependymomas of the spinal cord and cauda equina: An analysis of 26 cases and a review of the literature

Asazuma

Toyama

Suzuki³

et al. 1999

Spinal Cord

View full text Add to dashboard Cite

Study design: Retrospective review. Objectives: To clarify the clinical features of patients with spinal ependymomas and to compare the clinical results between the patients in whom microsurgical technique and spinal cord monitoring were used intraoperatively and the patients in whom they were not used. Setting: Keio University Hospital, Tokyo, Japan. Methods: Twenty-six consecutive patients with spinal ependymomas were treated surgically between 1958 and 1995. All patients underwent tumor resection through a posterior approach. Complete tumor resection was possible in 15 patients (57.7%), and subtotal tumor resection (more than 90%) was done in two patients (7.7%). Only a partial tumor resection (less than 90%) was performed in the remainder of the patients (34.6%). The operative results of the patients were evaluated by the Japanese Orthopaedic Association Scoring System (JOA score) and its recovery rate. Results: The overall average recovery rate was 18.3%. The mean recovery rate was 14.4% in cervical lesion, 11.1% in thoracic lesion and 40% in lumbar lesion. The recovery rate of eight patients with cervical ependymomas who underwent tumor resection under both microscopic surgical procedure and intraoperative spinal cord monitoring was 37.1% although the recovery rate of the rest of the patients was 71.6%. There was a statistical di erence between the two groups (P50.02). The survival rate of patients following complete excision was statistically better compared to that of patients after incomplete resection. Conclusion: Both microsurgical technique and spinal cord monitoring are indispensable to achieve total removal of ependymomas and to obtain improvement of neurological recovery.

show abstract

Management of intramedullary spinal cord tumors.

Cited by 163 publications

References 0 publications

Prognostic factors in intramedullary astrocytomas: a literature review

Prognostic factors in intramedullary astrocytomas: a literature review

Surgical outcomes of spinal cord astrocytomas

Ependymomas of the spinal cord and cauda equina: An analysis of 26 cases and a review of the literature

Contact Info

Product

Resources

About