Intramedullary ependymomas: long-term outcomes of surgical treatment

Abstract

Objective. The study was aimed at assessing the long-term outcomes of surgical treatment of intramedullary ependymomas. Material and Methods. Spinal ependymomas were detected in 91 (20.2 %) of 450 operated patients. Intramedullary lo- cation of the tumor was diagnosed in 41 (45.0 %) patients. Ependymoma was benign in 78.1 % of cases and anaplastic in 9 (21.9 %) cases. Radical removal of the tumor was achieved in 36 (87.8 %) patients, and subtotal resection was performed in 5 cases (12.2 %). Results. Long-term persistence of severe neurological symptoms was observed in 6 (24.0 %) patients. Structural changes in the spine associated with surgical intervention were detected only in 12.0 % of cases; relapses and continued tumor growth was observed in 16.1 % of cases. Early postoperative mortality was 4.8 % (2 patients out of 41 died). Four more patients died in the late postoperative period, so that the overall mortality was 14.6 %. Five-year survival rate of patients was 80.6 %. Conclusion. Radical surgery is an effective treatment for intramedullary ependymomas. The prognosis of intramedullary ependymoma may be considered favorable in the case of radical removal of the tumor, its benign nature, and good func- tional outcome of surgical treatment.

Keywords

• long-term period
• intramedullary tumors
• ependymoma
• spinal cord
• radical removal
• functional outcomes of surgery
• independence
• adaptation level