Outcomes after surgery and radiotherapy for spinal myxopapillary ependymoma: update of the MD Anderson Cancer Center experience
| Autor: | Ganesh Rao, Laurence D. Rhines, Anita Mahajan, Eric L. Chang, Jing Li, Terri S. Armstrong, Chiaojung Jillian Tsai, Claudio E. Tatsui, Ian E. McCutcheon, Yucai Wang, Pamela K. Allen, Paul D. Brown, Moshe H. Maor |
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| Rok vydání: | 2014 |
| Předmět: |
Ependymoma
Adult Male medicine.medical_specialty Adolescent medicine.medical_treatment Kaplan-Meier Estimate Disease-Free Survival Young Adult medicine Combined Modality Therapy Humans Young adult Child Proportional Hazards Models Retrospective Studies Spinal Neoplasms Proportional hazards model business.industry Hazard ratio Cancer Retrospective cohort study Middle Aged medicine.disease Surgery Radiation therapy Female Neurology (clinical) Neoplasm Recurrence Local business |
| Zdroj: | Neurosurgery. 75(3) |
| ISSN: | 1524-4040 |
| Popis: | Background The role of radiotherapy after surgery for myxopapillary ependymoma (MPE) is unclear. Objective To review long-term outcomes after surgery, with or without radiation, for spinal MPE. Methods Fifty-one patients with spinal MPE treated from 1968 to 2007 were included. Associations between clinical variables and overall survival (OS), progression-free survival (PFS), and local control (LC) were tested with Cox regression analysis. Results The median age at diagnosis was 35 years (range, 8-63 years). Twenty patients (39%) had surgery alone, 30 (59%) had surgery plus radiotherapy (RT), and 1 (2%) had RT only. At a median follow-up of 11 years (range, 0.2-37 years), 10-year OS, PFS, and LC for the entire group were 93%, 63%, and 67%, respectively. Nineteen patients (37%) had disease recurrence, and the recurrence was mostly local (79%). Twenty-eight of 50 patients who had surgery (56%) had gross total resection; 10-year LC was 56% after surgery vs 92% after surgery and RT (log-rank P = .14); the median time of LC was 10.5 years for patients receiving gross total resection plus RT, and 4.75 years for gross total resection only (P = .03). Among 16 patients with subtotal resection and follow-up data, 10-year LC was 0% after surgery vs 65% for surgery plus RT (log-rank P = .008). On multivariate analyses adjusting for resection type, age older that 35 years at diagnosis and receipt of adjuvant radiation were associated with improved PFS (hazard ratio [HR]: 0.14, P = .003 and HR: 0.45, P = .009) and LC (HR: 0.22, P = .02 and HR: 0.45, P = .009). Conclusion Postoperative radiotherapy after resection of MPE was associated with improved PFS and LC. |
| Databáze: | OpenAIRE |
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