title: Outcome predictors in the management of spinal cord ependymoma.
abstract: The aim of this study was to determine predictors of functional outcome and survival in a retrospective cohort of spinal cord ependymomas treated at a single institution. Twenty-six patients who underwent treatment of spinal cord ependymoma at a single institution were retrospectively analysed. The clinicopathological features were reviewed and correlated with functional outcome (measured using the Frankel grade), recurrence (clinical or radiological), progression-free survival (PFS) and overall survival (OS). Seventy-nine percent of patients with complete excision had maintained or improved functional outcome, compared to 75% in the incomplete resection plus radiotherapy group. Patients with a good pre-operative Frankel grade tended to maintain their functional status, though this did not reach statistical significance (Fisher's Exact test, P = 0.090). Univariate analysis revealed that longer symptom duration prior to treatment was associated with poorer functional outcome (P = 0.006). Extent of resection and the use of adjuvant radiotherapy did not influence PFS or OS; however, early diagnosis and treatment are paramount in the management of spinal ependymoma if a good functional outcome is to be achieved.
authors.affiliation: Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool L9 7LJ, UK. gavin.quigley@thewaltoncentre.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: Gavin Quigley
authors.forename: Naeem
authors.initials: N
authors.lastname: Farooqi
authors.forename: Timothy J D
authors.initials: TJ
authors.lastname: Pigott
authors.forename: Gordon F G
authors.initials: GF
authors.lastname: Findlay
authors.forename: Robin
authors.initials: R
authors.lastname: Pillay
authors.forename: Neil
authors.initials: N
authors.lastname: Buxton
authors.forename: Michael D
authors.initials: MD
authors.lastname: Jenkinson
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D018572:Disease-Free Survival; D004806:Ependymoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome