The Results of Surgery, With or Without Radiotherapy, for Primary Spinal Myxopapillary Ependymoma: A Retrospective Study From the Rare Cancer Network

Alessia Pica, Robert Miller, Salvador VillÀ, Sidney P. Kadish, Yavuz Anacak, Huda Abusaris, Gokhan Ozyigit, Brigitta G. Baumert, Renata Zaucha, Guy Haller, Damien C. Weber

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Purpose: The aim of this study was to assess the outcome of patients with primary spinal myxopapillary ependymoma (MPE). Materials and Methods: Data from a series of 85 (35 females, 50 males) patients with spinal MPE were collected in this retrospective multicenter study. Thirty-eight (45%) underwent surgery only and 47 (55%) received postoperative radiotherapy (RT). Median administered radiation dose was 50.4 Gy (range, 22.2-59.4). Median follow-up of the surviving patients was 60.0 months (range, 0.2-316.6). Results: The 5-year progression-free survival (PFS) was 50.4% and 74.8% for surgery only and surgery with postoperative low- (<50.4 Gy) or high-dose (≥50.4 Gy) RT, respectively. Treatment failure was observed in 24 (28%) patients. Fifteen patients presented treatment failure at the primary site only, whereas 2 and 1 patients presented with brain and distant spinal failure only. Three and 2 patients with local failure presented with concomitant spinal distant seeding and brain failure, respectively. One patient failed simultaneously in the brain and spine. Age greater than 36 years (p = 0.01), absence of neurologic symptoms at diagnosis (p = 0.01), tumor size ≥25 mm (p = 0.04), and postoperative high-dose RT (p = 0.05) were variables predictive of improved PFS on univariate analysis. In multivariate analysis, only postoperative high-dose RT was independent predictors of PFS (p = 0.04). Conclusions: The observed pattern of failure was mainly local, but one fifth of the patients presented with a concomitant spinal or brain component. Postoperative high-dose RT appears to significantly reduce the rate of tumor progression.

Original languageEnglish (US)
Pages (from-to)1114-1120
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume74
Issue number4
DOIs
StatePublished - Jul 15 2009

Keywords

  • Myxopapillary ependymoma
  • Radiation therapy
  • Spinal tumor

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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