title: Pediatric intramedullary spinal cord tumors: a single center experience.
abstract: OBJECTIVE
  To evaluate clinical and radiological findings, pathological features and treatment modalities in pediatric patients with intramedullary spinal cord tumors.
  
  
  METHODS
  The medical records of 36 patients with intramedullary spinal tumors were reviewed for clinical, radiological and histopathological data, chemotherapy, radiotherapy, surgical resection, treatment responses, events, and final outcome. Survival analyses were performed.
  
  
  RESULTS
  The median age was 7.9 years (range: 1-16 years; male/female ratio:1.4). Majority of the tumors were histopathologically diagnosed as astrocytomas (n = 16, 44.4%) and ependymomas (n = 19, 52.8%); whereas one was unclassified glioma. Overall, 94% of the astrocytomas and 84% of the ependymomas were low-grade, only three tumors were high-grade. In one patient with ependymoma, histopathological grade was undetermined. The primary tumor was commonly located in thoracic (47%) and cervical segments (28%). All patients had undergone surgery (gross-total resection, 33%; subtotal resection, 45%; biopsy, 22%). Radiotherapy was administered to 26 patients (72%) and chemotherapy to 15 patients (42%). The 3-, 5- and 10-year overall survival rates were 72%, 63% and 56%, respectively; and event-free survival rates were 43%, 40% and 40%. Survival did not significantly differ with gender, age groups, lag-time, neurologic status, histopathological tumor type, tumor location, extent of resection, treatment, or treatment responses in univariate survival analyses. Survival rates were significantly higher in patients with low-grade tumors and in ependymoma patients with resected tumors.
  
  
  CONCLUSIONS
  Patients with low-grade tumors and those who underwent gross-total tumor resection had better prognosis. Surgery remains the main treatment in intramedullary spinal tumors. The role of radiotherapy and chemotherapy is limited and even controversial in low-grade tumors.
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey. Electronic address: tezerkutluk@gmail.com.
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Candaş
authors.initials: C
authors.lastname: Kafalı
authors.affiliation: Department of Preventive Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.affiliation: Department of Pathology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Söylemezoğlu
authors.affiliation: Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Zorlu
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Burça
authors.initials: B
authors.lastname: Aydın
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalçın
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Akyüz
authors.affiliation: Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
authors.forename: Münevver
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001254:Astrocytoma / Q000473:pathology; D002574:Cervical Vertebrae / Q000473:pathology; D059248:Chemoradiotherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004806:Ependymoma / Q000473:pathology; D005260:Female; D005910:Glioma / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D019635:Neurosurgical Procedures; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D013904:Thoracic Vertebrae / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Children; Intramedullary spinal tumors; Outcome; Treatment