Surgery for Primary Filum Terminale Ependymomas: Outcome and Prognostic Factors

• Published in: CNS neuroscience & therapeutics Vol. 20; no. 2; pp. 131 - 139
• Main Authors: Xie, Tian‐Hao, Chen, Xian‐Zhen, Qian, Jun, Lu, Yi‐Cheng, Jiang, Yi‐Kun, Zhang, Lei, Hu, Guo‐Han, Ding, Xue‐Hua, Luo, Chun
• Format: Journal Article
• Language: English
• Published: Oxford Wiley-Blackwell 01.02.2014; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Adolescent; Adult; Analysis of Variance; Biological and medical sciences; Cauda Equina - pathology; Central nervous system; Ependymoma - diagnosis; Ependymoma - mortality; Ependymoma - surgery; Female; Follow-Up Studies; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Investigative techniques, diagnostic techniques (general aspects); Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Nervous system; Neurology; Original; Outcome; Peripheral Nervous System Neoplasms - diagnosis; Peripheral Nervous System Neoplasms - mortality; Peripheral Nervous System Neoplasms - surgery; Primary filum terminale ependymoma; Prognostic factor; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Traumas. Diseases due to physical agents; Treatment Outcome; Tumors of the nervous system. Phacomatoses; Young Adult; Nervous system diseases; Prognosis; Treatment; Glioma; Surgery; Outcome; Central nervous system disease; Prognostic factor; Tumor; Primary filum terminale ependymoma; Ependymoma
• ISSN: 1755-5930; 1755-5949
• DOI: 10.1111/cns.12174

Summary Introduction Primary filum terminale ependymoma (PFTE) is a unique type of ependymomas and locates on extramedullary site. However, the clinical features and prognostic factors of PFTE are still unknown due to its rarity. Aim This study aimed to evaluate the clinical features, outcomes, and prognostic factors of PFTE in the largest series of cases. Result Thirty‐eight patients were included in this study. Gross total removal (GTR) of the tumors was achieved in 33(87%) patients. Five (13%) patients had subtotal resection (STR). For the residual tumors, postoperative radiotherapy increased the interval between the first surgery and tumor regrowth (P = 0.063). Six patients had local recurrence/progression. Univariate analysis identified STR(P = 0.001), unencapsulated tumor (P = 0.018), tumor involving more than two vertebral columns (P = 0.005), and tumor invading sacral canal(P < 0.001) as predictors of tumor recurrence. In addition, 36 (95%) patients had stable or improved neurological status directly after surgery. Klekamp–Samii score was better correlated with the symptoms than McCormick scale. Conclusion Extent of surgical removal, tumor size, tumor location, and the integrity of tumor capsule are the prognostic factors of PFTEs, and the intrasacral PFTEs always have a poor prognosis.