Pediatric intramedullary spinal cord tumors: is surgery alone enough?
Pediatric intramedullary spinal cord tumors occur infrequently with limited data on treatment strategies and outcome. Over an 11-year period, 44 patients with such tumors who were primarily managed by radical surgery were retrospectively reviewed. The majority of tumors (42/44, 95%) were in the cervical or thoracic spine and were histologically low grade. Gross total resection was achieved in 73% (32/44). At a median follow-up of 45 months, 11% (5/44) had severe weakness (modified McCormick scale IV-V), 66% (29/44) had mild-moderate deficits (I-III), and 16% (7/44) had sphincter dysfunction. Tumor recurrence rate was 18% (8/44) after a mean period of 54 months. Age, number of involved spinal cord segments and extent of surgical resection did not significantly impact on tumor recurrence rates (p = 0.28, 0.44 and 0.13, respectively). The only significant prognostic factor was histological type; mixed or higher grade tumors having a higher recurrence rate (p = 0.04). Radical surgery for intraspinal tumors can achieve long tumor-free survival without requiring adjuvant therapy.
Goh
K Y
KY
Department of Pediatric Neurosurgery, Beth Israel Institute for Neurology and Neursurgery, New York, NY 10128, USA.
Velasquez
L
L
Epstein
F J
FJ
D000293:Adolescent; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018303:Ganglioglioma / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications; D012189:Retrospective Studies; D012600:Scoliosis / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*