Long-term outcome of patients with spinal myxopapillary ependymoma

Treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network

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

Research output: Contribution to journalArticle

30 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)588-595
Number of pages8
JournalNeuro-Oncology
Volume17
Issue number4
DOIs
StatePublished - Oct 9 2014

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Ependymoma
Neoplasms
Radiotherapy
Therapeutics
Treatment Failure
Recurrence
Disease-Free Survival
Adjuvant Radiotherapy
Glioma
Medical Records
Young Adult
Multivariate Analysis
Drug Therapy

Keywords

  • Myxopapillary ependymoma
  • Radiotherapy
  • Spinal failures
  • Spinal tumors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Clinical Neurology

Cite this

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; Villà, Salvador; Zaucha, Renata; Pica, Alessia; Poortmans, Philip; Anacak, Yavuz; Ozygit, Gokhan; Baumert, Birgitta; Haller, Guy; Preusser, Matthias; Li, Jing.

In: Neuro-Oncology, Vol. 17, No. 4, 09.10.2014, p. 588-595.

Research output: Contribution to journalArticle

Weber, DC, Wang, Y, Miller, R, Villà, S, Zaucha, R, Pica, A, Poortmans, P, Anacak, Y, Ozygit, G, Baumert, B, Haller, G, Preusser, M & Li, J 2014, 'Long-term outcome of patients with spinal myxopapillary ependymoma: Treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network', Neuro-Oncology, vol. 17, no. 4, pp. 588-595. https://doi.org/10.1093/neuonc/nou293
Weber, Damien C. ; Wang, Yucai ; Miller, Robert ; Villà, Salvador ; Zaucha, Renata ; Pica, Alessia ; Poortmans, Philip ; Anacak, Yavuz ; Ozygit, Gokhan ; Baumert, Birgitta ; Haller, Guy ; Preusser, Matthias ; Li, Jing. / Long-term outcome of patients with spinal myxopapillary ependymoma : Treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network. In: Neuro-Oncology. 2014 ; Vol. 17, No. 4. pp. 588-595.
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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.",
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AU - Miller, Robert

AU - Villà, Salvador

AU - Zaucha, Renata

AU - Pica, Alessia

AU - Poortmans, Philip

AU - Anacak, Yavuz

AU - Ozygit, Gokhan

AU - Baumert, Birgitta

AU - Haller, Guy

AU - Preusser, Matthias

AU - Li, Jing

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AB - 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.

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