National trends in management of adult myxopapillary ependymomas

Scarpelli, Daphne B.; Turina, Claire B; Kelly, Patrick; Khudanyan, Arpine; Jaboin, Jerry J.; McClelland, Shearwood

doi:10.1016/j.jocn.2019.12.049

Cited by 6 publications

(3 citation statements)

References 34 publications

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“…In retrospective NCDB cohort study of 753 adult patients diagnosed with spinal myxopapillary ependymomas, Scarpelli et al showed that African American race was significantly associated with decreased use of radiation therapy. 28 Whereas, in another NCDB study of 10 458 patients with spinal meningiomas, Yolcu et al found that African American race did not influence the decision for radiation only, but was an independent predictor of any radiation plus surgery (OR: 2.19) or adjuvant radiation (OR: 2.05). 29 Interestingly, in a retrospective cohort study of 183 patients diagnosed with spinal cord gliomas, Abdel-Wahab et al demonstrated that race was not significantly associated with use of surgery only or postoperative receipt of radiation for patients with ependymoma or astrocytoma.…”

Section: Discussionmentioning

confidence: 94%

Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis

Elsamadicy

Freedman

Koo

et al. 2021

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: The influence that race has on mortality rates in patients with spinal cord tumors is relatively unknown. The aim of this study was to investigate the influence of race on the outcomes of patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges. Methods: The Surveillance, Epidemiology, and End Results (SEER) Registry was used to identify all patients with a code for primary malignant or nonmalignant tumor of the spinal cord (C72.0) or spinal meninges (C70.1) from 1973 through 2016. Racial groups (African-American/Black vs. White) were balanced using propensity-score (PS) matching using a non-parsimonious 1:1 nearest neighbor matching algorithm. Overall survival (OS) estimates were obtained using the Kaplan-Meier method and compared across non-PS-matched and PS-matched groups using log-rank tests. Associations of survival with clinical variables was assessed using doubly robust Cox proportional-hazards (CPH) regression analysis. Results: There were a total of 7,498 patients identified with 648 (6.8%) being African American. African-American patients with primary intradural spine tumors were more likely to die of all causes than were White patients in both the non-PS-matched [HR: 1.26, 95% CI: (1.04, 1.51), P = 0.01] and PS-matched cohorts [HR: 1.64, 95% CI: (1.28, 2.11), P < 0.0001]. On multivariate CPH regression analysis age at diagnosis [HR: 1.03, 95% CI: (1.02, 1.05), P < 0.0001], race [HR: 1.82, 95% CI: (1.22, 2.74), P = 0.004), and receipt of RT [HR: 2.62, 95% CI: (1.56, 4.37), P = 0.0002) were all significantly associated with all-cause mortality, when controlling for other demographic, tumor, and treatment variables. Conclusions: Our study provides population-based estimates of the prognosis for patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges and suggests that race may impact all-cause mortality.

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Section: Discussionmentioning

confidence: 94%

Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis

Elsamadicy

Freedman

Koo

et al. 2021

Global Spine Journal

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“…Due to the rarity of MPE, annual occurrence of 0.05-0.08 per 100,000 people, non-surgical management (radiotherapy or chemotherapy) can vary; however, surgery remains the primary treatment with preference for gross total resection as in our patient. 7 On neuro-ophthalmology follow-up one-month post-op, there was improvement in the disc edema (Figure 2B). She also reported improvement in her headaches and vision.…”

Section: Sectionmentioning

confidence: 96%

Clinical Reasoning: A 32-Year-Old Woman With Tunnel Vision and Back Pain

et al. 2022

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The incidence of new onset visual disturbances in emergency departments across the country are frequent. A detailed history of events and thoughtful physical examination may produce a diagnosis; however, atypical cases may require further diagnostic testing to explain symptoms. We present a case of presumed increased intracranial pressure with atypical findings on diagnostic testing, which allowed our team to explore a broader differential diagnosis. This clinical reasoning manuscript will benefit students, residents, and attendings alike to continue to uncover etiologies for symptoms of increased intracranial pressure and review differential diagnoses in similar presentations.

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“…In general, the consensus optimal treatment strategy is similar to ependymoma at large, wherein maximal safe surgical resection is recommended [ 11 , 12 , 13 ]. The role of chemotherapy and radiotherapy remains controversial [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

Wang,

Rooney,

Alvarez-Breckenridge

et al. 2024

Cancers

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(1) Background: Myxopapillary ependymoma (MPE) is a rare tumor of the spine, typically slow-growing and low-grade. Optimal management strategies remain unclear due to limited evidence given the low incidence of the disease. (2) Methods: We analyzed data from 1197 patients with spinal MPE from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2020). Patient demographics, treatment modalities, and survival outcomes were examined using statistical analyses. (3) Results: Most patients were White (89.9%) with a median age at diagnosis of 42 years. Surgical resection was performed in 95% of cases. The estimated 10-year overall survival was 91.4%. Younger age (hazard ratio (HR) = 1.09, p < 0.001) and receipt of surgery (HR = 0.43, p = 0.007) were associated with improved survival. Surprisingly, male sex was associated with worse survival (HR = 1.86, p = 0.008) and a younger age at diagnosis compared to females. (4) Conclusions: This study, the largest of its kind, underscores the importance of surgical resection in managing spinal MPE. The unexpected association between male sex and worse survival warrants further investigation into potential sex-specific pathophysiological factors influencing prognosis. Despite limitations, our findings contribute valuable insights for guiding clinical management strategies for spinal MPE.

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National trends in management of adult myxopapillary ependymomas

Cited by 6 publications

References 34 publications

Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis

Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis

Clinical Reasoning: A 32-Year-Old Woman With Tunnel Vision and Back Pain

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

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