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Clinical characteristics and long-term surgical outcome of spinal myxopapillary ependymoma: a French cohort of 101 patients

  • Clinical Study
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Abstract

Purpose

Myxopapillary ependymoma (MPE) is the most frequent tumor affecting the medullary conus. The surgical therapeutic management is still debated and only few studies have focused on the postoperative clinical outcome of patients. This study aimed to demonstrate long-term postoperative outcome and to assess the predictive factors of recurrence as well as the clinical evolution of these patients.

Methods

From 1984 to 2019, in four French centers, 101 adult patients diagnosed with MPE were retrospectively included.

Results

Median age at surgery was 39 years. Median tumor size was 50 mm and lesions were multifocal in 13% of patients. All patients benefited from surgery and one patient received postoperative radiotherapy. Gross total resection was obtained in 75% of cases. Sixteen percent of patients presented recurrence after a median follow-up of 70 months. Progression free survival at 5 and 10 years were respectively estimated at 83% and 79%. After multivariable analysis, sacral localization, and subtotal resection were shown to be independently associated with tumor recurrence. 85% of the patients had a favorable evolution concerning pain. 12% of the patients presented a postoperative deterioration of sphincter function and 4% of motor function.

Conclusion

Surgery alone is an acceptable option for MPE patients. Patients with sacral location or incomplete resection are at high risk of recurrence and should be carefully monitored.

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Data availability

Anonymized data will be shared on request from any qualified investigator.

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Funding

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, 47–83, boulevard de L’Hôpital, 75651, Paris Cedex 13, France

    Anne-Sophie Montero, Aymeric Amelot, Alexandre Carpentier & Bertrand Mathon

  2. Department of Neuropathology, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France

    Suzanne Tran & Franck Bielle

  3. Inserm U 1127, CNRS UMR 7225, UMR S 1127, Paris Brain Institute, ICM, Sorbonne Université, 75013, Paris, France

    Félix Berriat, Franck Bielle & Bertrand Mathon

  4. Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France

    Guillaume Lot

  5. Department of Neurosurgery, Hôpital Foch, Suresnes, France

    Stephan Gaillard

  6. INSERM U 1016, Institut Cochin, 75014, Paris, France

    Chiara Villa

  7. NCRS UMR 8104, 75014, Paris, France

    Chiara Villa

  8. Université Paris Descartes-Université de Paris, 75006, Paris, France

    Chiara Villa

  9. Department of Pathological Cytology and Anatomy, Foch Hospital, 92151, Suresnes, France

    Chiara Villa

  10. Department of Pathological Cytology and Anatomy, Lariboisière Hospital, APHP, 75010, Paris, France

    Marc Polivka

  11. Department of Neuropathology, GHU Paris-Sud-Hôpital Bicêtre, le Kremlin-Bicêtre, France

    Clovis Adam

  12. Inserm, CNRS, UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, 75013, Paris, France

    Ahmed Idbaih

  13. Department of Radiotherapy, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France

    Loïc Feuvret

  14. Department of Neurosurgery, Hôpitaux Universitaires Paris-Sud, AP-HP, Centre Hospitalier Universitaire Bicêtre, Paris, France

    Fabrice Parker

Authors
  1. Anne-Sophie Montero
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  2. Suzanne Tran
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  3. Aymeric Amelot
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  4. Félix Berriat
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  5. Guillaume Lot
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  6. Stephan Gaillard
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  7. Chiara Villa
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  8. Marc Polivka
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  9. Clovis Adam
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  10. Ahmed Idbaih
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  11. Loïc Feuvret
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  12. Alexandre Carpentier
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  13. Fabrice Parker
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  14. Franck Bielle
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  15. Bertrand Mathon
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Contributions

A.S.M and B.M. Conceptualization; A.S.M and B.M. methodology; all the authors. validation; A.S.M., F.Be. and B.M. formal analysis; A.S.M., S.T., G.L., S.G., M.P., C.A., F.P., A.I., L.F., F.Bi and B.M. investigation; B.M. resources; A.S.M., S.T., G.L., S.G., M.P., C.A., F.P., A.I., L.F., F.Bi and B.M. data curation; A.S.M., A.A. and B.M. writing—original draft preparation; all the authors writing—review and editing; B.M. and A.C. supervision. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Bertrand Mathon.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The protocol can be found in the reference methodology MR003 chapter adopted by the Commission Nationale de l’Informatique et des Libertés (No 2219024 v0) in agreement with the policies of the University Hospitals involved in this project.

Consent to participate

In accordance with the ethical standards of our hospital’s institutional review board, the Committee for the Protection of Human Subjects, and French law, written informed consent was not needed for demographic, physiological and hospital-outcome data analyses because this observational study did not modify existing diagnostic or therapeutic strategies; however, patients were informed of their inclusion in the study.

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Montero, AS., Tran, S., Amelot, A. et al. Clinical characteristics and long-term surgical outcome of spinal myxopapillary ependymoma: a French cohort of 101 patients. J Neurooncol 152, 491–499 (2021). https://doi.org/10.1007/s11060-021-03717-7

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  • DOI: https://doi.org/10.1007/s11060-021-03717-7

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