Long term outcomes following surgical resection of myxopapillary ependymomas.

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Neurosurg Rev. 2009 Jul;32(3):321-34; discussion 334. Epub 2009 Feb 17.
Long term outcomes following surgical resection of myxopapillary ependymomas.
Bagley CA, Wilson S, Kothbauer KF, Bookland MJ, Epstein F, Jallo GI.Division of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.
Myxopapillary
ependymomas, a specific tumor variant of spinal cord ependymomas, occur
most commonly in the lumbosacral region. During the study period, 1,013
patients underwent surgery for spinal cord tumors. Fifty-two of the
patients had a myxopapillary ependymoma. Forty-eight of these patients
underwent surgery at our institutions. There were four patients who
came for consultations only. Fourteen pediatric patients were diagnosed
with myxopapillary ependymoma. The overall average age at which a
patient was diagnosed was 31.8 years. The average age a child was
diagnosed was 12.6 years. The adult mean age was 38.7 years.
 
The
clinical presentation was of a slow, indolent course, with average
symptom duration of 20.8 months. Overall, the pediatric patients had a
much more aggressive clinical course with a much higher rate of local
recurrence and dissemination of the tumor within the neural axis (64%
versus 32%). The median time to disease recurrence was 88 months for
the entire group. The overall survival after 11.5 years of follow-up
was 94%. The optimal management of patients harboring myxopapillary
ependymomas remains somewhat controversial. Excellent outcomes may be
obtained, however, with the use of aggressive surgical techniques. No
clear benefit for adjunctive chemotherapy, and radiation therapy was
demonstrated.