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Radiological outcomes after surgery for spinal myxopapillary ependymoma in the Republic of Ireland
EANS Academy. Duddy J. Sep 27, 2019; 276073; EP04142
Abstract
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This is a retrospective case series designed to determine the rate of radiological recurrence in patients who had surgery for spinal myxopapillary ependymoma in both adult neurosurgical centres located in the Republic of Ireland. All patients who had surgery for histologically-confirmed new diagnoses of myxopapillary ependymoma from May 2012 to May 2018 were included. Patients who had recurrence of a previously-diagnosed myxopapillary ependymoma during the study period, or a higher grade ependymoma were excluded.
Subjects were identified from prospectively-maintained neuropathology and spinal surgery databases. All relevant demographic details were recorded. Outcome measure was radiological recurrence as reported on follow-up MRI scans.
33 patients were identified. Average age was 45.73 years (median 44). 19 (57.57%) patients were male. Average length of follow-up was 25.43 months (median 21.50; range 1.5-73). 24 patients had gross total resection (GTR) of the tumour, 8 had subtotal resection and 1 had biopsy only. Of the 24 who had GTR, 4 had no imaging follow-up. 1 of these died from an unrelated cause prior to follow-up imaging. One other patient died of an unrelated haematological malignancy. Of the remaining 19, 100% had no tumour recurrence on surveillance imaging.
Of the 8 patients who had subtotal resection, 7 had further treatment with adjuvant spinal radiotherapy while 1 had no further treatment. 6 showed stable appearances on imaging follow-up while the other 2 patients showed increased tumour size after 32 and 54 months follow-up, respectively.
In conclusion, gross total resection of myxopapillary ependymoma reduces the recurrence rate. Subtotal resection followed by radiotherapy can maintain stable radiological appearances in large tumours which cannot be completely resected.
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