KEY TAKEAWAYS
- The study aimed to investigate the impact of the EOR on survival outcomes in a large contemporary cohort of patients with spinal ependymoma.
- Researchers noticed a significant improvement in PFS when GTR was achieved in a large contemporary series of patients with adult spinal ependymoma.
Primary treatment of spinal ependymomas involves surgical resection, a procedure aimed at removing as much of the tumor as possible. However, recurrence rates remain high, ranging between 50% and 70%. Previous studies examining the association between the extent of resection (EOR) and survival outcomes in brain cancer have been hindered by small sample sizes and outdated data, leading to a heterogeneous patient population.
Mark A. Davison and the team aimed to assess the influence of EOR on survival outcomes, mainly on the overall survival (OS) and progression-free survival (PFS) in managing patients with spinal ependymomas and informing future treatment strategies.
They performed an inclusive analysis of adult patients diagnosed with spinal ependymoma between 2006 and 2021, identified from an institutional registry. The study included patients who underwent primary surgical resection at the institution, received at least one routine follow-up MRI and had a pathologic diagnosis of ependymoma.
Patient records were reviewed for demographic information, EOR, lesion characteristics, and pre-/post-operative neurologic symptoms. EOR was classified as gross total resection (GTR) or subtotal resection (STR). Statistical analysis utilizing the log-rank test was employed to compare OS and PFS between patient groups.
About 69 patients met the inclusion criteria, with 79.7% benefiting from GTR. The population comprised 56.2% males with an average age of 45.7 years and a median follow-up duration of 58 months. Cox multivariate analysis revealed a significant enhancement in PFS associated with GTR attainment (P <.001).
Patients who were independently ambulatory prior to surgery exhibited superior PFS (P <.001) and OS (P =.05). In univariate analyses, patients with a syrinx experienced improved PFS (p =.03) and were more likely to benefit from GTR (P =.01). Conversely, OS was unaffected by the EOR (P =.78).
The study concluded that in this large, contemporary series of adult spinal ependymoma patients, improvements in PFS were demonstrated when GTR was achieved.
The study received no funds.
Source: https://link.springer.com/article/10.1007/s11060-024-04623-4#article-info
Davison, M.A., Lilly, D.T., Patel, A.A. et al. (2024). “Clinical presentation and extent of resection impacts progression-free survival in spinal ependymomas.” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04623-4
