Quality of life and return to work and sports after spinal ependymoma resection

Abstract

Adult spinal ependymoma presents a rare low-grade tumor entity. Due to its incidence peak in the fourth decade of life, it mostly affects patients during a professionally and physically active time of life. We performed a retrospective monocentric study, including all patients operated upon for spinal ependymoma between 2009 and 2020. We prospectively collected data on professional reintegration, physical activities and quality-of-life parameters using EQ-5D and SF-36. Issues encountered were assessed using existing spinal-cord-specific questionnaires and free-text questions. In total, 65 of 114 patients agreed to participate. Most patients suffered from only mild pre- and postoperative impairment on the modified McCormick scale, but 67% confirmed difficulties performing physical activities in which they previously engaged due to pain, coordination problems and fear of injuries after a median follow-up of 5.4 years. We observed a shift from full- to part-time employment and patients unable to work, independently from tumor dignity, age and neurological function. Despite its benign nature and occurrence of formal only mild neurological deficits, patients described severe difficulties returning to their preoperative physical activity and profession. Clinical scores such as the McCormick grade and muscle strength may not reflect the entire self-perceived impairment appropriately.

Resection of Intramedullary Hemangioblastoma: Timing of Surgery and Its Impact on Neurological Outcome and Quality of Life

“…Neurological patients’ status was measured according to the modified McCormick Scale [ 16 , 17 ], ranging from I (no symptoms or minimal dysesthesia) to V (paraplegic/quadriplegic). The status was evaluated both before and after surgery independently by two of the authors (MS and SR).…”

“…These quality indicators include 90-day readmission, reoperation, mortality rates, length of hospital stay (LOS), rates of nosocomial infections and surgical site infections (SSI) as well as quality-of-life (QoL) assessment [ 12 , 13 , 14 , 15 ]. QoL assessment after surgery has helped to predict potential long-term outcomes for other tumor entities, such as spinal meningiomas [ 16 ] or ependymomas [ 17 ], and has significantly improved patient care, allowing the weighing of a surgical strategy against conservative treatment.…”

Rückkehr in das Erwerbsleben nach Krebs – eine systematische Übersichtsarbeit zu Prädiktoren in Deutschland

“…Bei den qualitativen Methoden handelt es sich um einmalige semi-strukturierte Interviews, die mit qualitativer Inhaltsanalyse nach Mayring und der Grounded-Theory nach Strauss und Corbin ausgewertet wurden. Die meisten quantitativen Studien waren Kohortenstudien (75 %), daneben wurden fünf Querschnittstudien [28][29][30][31][32], eine Studie im quasi-experimentellen Design [33] und eine clusterrandomisierte Studie [34] identifiziert. Die Stichprobengröße bei den quantitativen Studien variierte von N = 40 [35] bis N = 4.529 [36].…”

Timing of Resection of Spinal Meningiomas and Its Influence on Quality of Life and Treatment

“…Surgery in advanced stages may relief symptoms in most cases, but the recovery would not be as good as in patients with mild symptoms. A treatment strategy of wait and see, which is often propagated, seems to be less recommended like in other intradural tumors [21,[27][28][29].…”