Long-term outcome of patients with spinal myxopapillary ependymoma : treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network

Weber, Damien C.; Wang, Yucai; Miller, Robert; Villa, Salvador; Zaucha, Renata; Pica, Alessia; Poortmans, Philip; Anacak, Yavuz; Ozygit, Gokhan; Baumert, Birgitta; Haller, Guy; Preusser, Matthias; Li, Jing

doi:10.1093/NEUONC/NOU293

Title

Long-term outcome of patients with spinal myxopapillary ependymoma : treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network

Author

Weber, Damien C.

Wang, Yucai

Miller, Robert

Villa, Salvador

Zaucha, Renata

Pica, Alessia

Poortmans, Philip

Anacak, Yavuz

Ozygit, Gokhan

Baumert, Birgitta

Haller, Guy

Preusser, Matthias

Li, Jing

Abstract

Background. Spinal myxopapillary ependymomas (MPEs) are slowly growing ependymal gliomas with preferential manifestation in young adults. The aim of this study was to assess the outcome of patients with MPE treated with surgery, radiotherapy (RT), and/or chemotherapy. Methods. The medical records of 183 MPE patients (male: 59%) treated at the MD Anderson Cancer Center and 11 institutions from the Rare Cancer Network were retrospectively reviewed. Mean patient' age at diagnosis was 35.5 +/- 15.8 years. Ninety-seven (53.0%) patients underwent surgery without RT, and 86 (47.0%) were treated with surgery and/or RT. Median RT dose was 50.4 Gy. Median followup was 83.9 months. Results. Fifteen (8.2%) patients died, 7 of unrelated cause. The estimated 10-year overall survival was 92.4% (95% CI: 87.7-97.1). Treatment failure was observed in 58 (31.7%) patients. Local failure, distant spinal relapse, and brain failure were observed in 49 (26.8%), 17 (9.3%), and 11 (6.0%) patients, respectively. The estimated 10-year progression-free survival was 61.2% (95% CI: 52.8-69.6). Age (<36 vs >= 36 y), treatment modality (surgery alone vs surgery and RT), and extent of surgery were prognostic factors for local control and progression-free survival on univariate and multivariate analysis. Conclusions. In this series, treatment failure of MPE occurred in approximately one third of patients. The observed recurrence pattern of primary spinal MPE was mainly local, but a substantial number of patients failed nonlocally. Younger patients and those not treated initially with adjuvant RT or not undergoing gross total resection were significantly more likely to present with tumor recurrence/progression.

Language

English

Source (journal)

Neuro-oncology. - Place of publication unknown

Publication

Place of publication unknown : 2015

ISSN

1522-8517

DOI

10.1093/NEUONC/NOU293

Volume/pages

17 :4 (2015) , p. 588-595