Outcome predictors in the management of spinal myxopapillary ependymoma: An integrative survival analysis

Sunil Kukreja, Sudheer Ambekar, Mayur Sharma, Anthony Hunkyun Sin, Anil Nanda

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Objectives The results in earlier studies have described a variable association with age, extent of resection, and radiotherapy (RT) correlating with the survival of myxopapillary ependymomas. The aim of our study is to perform a survival analysis on patient data gathered from a comprehensive review of the literature and determine the influence of these factors on progression-free (PFS) and overall survival (OS). Methods A PubMed search was performed to select the articles containing information about the critical events (recurrence/death), time to events, and treatment characteristics (extent of resection with or without RT) in the patients with spinal myxopapillary ependymomas. Results A total of 337 patients with information regarding the critical events, time to events, and treatment characteristics was selected for the inclusion. Patients in gross-total resection group had better PFS and OS (P = 0.001, P = 0.000 respectively). The patients in older age group (>35 years) had better PFS (P = 0.008). Overall PFS did not improve if RT was combined with surgery compared with surgery alone; however, the adjuvant RT benefitted the patients age ≤35 years. RT dose >50 Gy had significant influence on the PFS (P = 0.034). Conclusion Gross-total resection plays the most important role in improving PFS and OS. Older patients had better PFS; however, the influence of adjuvant RT was significant in younger age groups. A dose of > 50 Gy improves the results, but a randomized controlled study is warranted to arrive at a definite conclusion.

Original languageEnglish (US)
Pages (from-to)852-859
Number of pages8
JournalWorld Neurosurgery
Volume83
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Keywords

  • Integrative analysis
  • Myxopapillary spendymoma
  • Spine
  • Survival

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