title: Spinal cord gliomas: A multi-institutional retrospective analysis.
abstract: OBJECTIVE
  To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas.
  
  
  METHODS
  Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed.
  
  
  RESULTS
  A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01).
  
  
  CONCLUSIONS
  Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS.
authors.affiliation: Department of Radiation Oncology, University of Miami, Miami, FL, USA. mwahab@med.miami.edu
authors.forename: May
authors.initials: M
authors.lastname: Abdel-Wahab
authors.forename: Blessing
authors.initials: B
authors.lastname: Etuk
authors.forename: James
authors.initials: J
authors.lastname: Palermo
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: John
authors.initials: J
authors.lastname: Kresl
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yapicier
authors.forename: Gail
authors.initials: G
authors.lastname: Walker
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Scheithauer
authors.forename: Edward
authors.initials: E
authors.lastname: Shaw
authors.forename: Charles
authors.initials: C
authors.lastname: Lee
authors.forename: Walter
authors.initials: W
authors.lastname: Curran
authors.forename: Terry
authors.initials: T
authors.lastname: Thomas
authors.forename: Arnold
authors.initials: A
authors.lastname: Markoe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004806:Ependymoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis