Spinal Cord Ependymoma: Radical Surgical Resection and Outcome

Abstract OBJECTIVE Several authors have noted increased neurological deficits and worsening dysesthesia in the postoperative period in patients with spinal cord ependymoma. We describe the neurological progression and pain evolution of these patients over the 1-year period after surgery. In addition, our favored method of en bloc tumor resection is illustrated, and the rate of complications, recurrence, and survival in this group of patients is addressed. METHODS We operated on 26 patients (12 male and 14 female) with low-grade spinal cord ependymomas between 1975 and 2001. The median age at diagnosis was 42 years. Tumors extended into the cervical cord in 13 patients, the thoracic cord in 7 patients, and the conus medullaris in 6 patients. Eleven patients had previous surgery and/or radiation therapy. RESULTS We achieved a gross total resection in 88% of patients, whereas 8% had a subtotal resection and 4% had a biopsy. Only 1 patient developed a recurrence over a mean follow-up period of 31 months. CONCLUSION We conclude that radical surgical resection of spinal cord ependymomas can be safely achieved in the majority of patients. A trend toward neurological improvement from a postoperative deficit can be expected between 1 and 3 months after surgery and continues up to 1 year. Postoperative dysesthesias begin to improve within 1 month of surgery and are significantly better by 1 year after surgery. The best predictor of outcome is the preoperative neurological status.

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Microsurgical resection of intramedullary spinal cord ependymoma

Neurosurgical FOCUS ◽

10.3171/2014.v3.focus14276 ◽

2014 ◽

Vol 37 (v2supplement) ◽

pp. Video9

Author(s):

Paul C. McCormick

Keyword(s):

Spinal Cord ◽

Growth Rate ◽

Spinal Cord Tumor ◽

Intramedullary Spinal Cord ◽

Clear Margin ◽

Intramedullary Spinal Cord Tumor ◽

Link Type ◽

Microsurgical Resection ◽

Spinal Cord Ependymoma ◽

Posterior Midline

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy.The video can be found here: http://youtu.be/lcHhymSvSqU.

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Recurrent Mesenchymal Hamartoma Associated with 19q Translocation. A Call for More Radical Surgical Resection

European Journal of Pediatric Surgery ◽

10.1055/s-2005-873072 ◽

2006 ◽

Vol 16 (1) ◽

pp. 64-67 ◽

Cited By ~ 21

Author(s):

K. Sharif ◽

P. Ramani ◽

H. Lochbühler ◽

R. Grundy ◽

J. de Ville de Goyet

Keyword(s):

Surgical Resection ◽

Mesenchymal Hamartoma ◽

Radical Surgical Resection

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EPEN-01. OUTCOME OF YOUNG CHILDREN WITH SUPRATENTORIAL EPENDYMOMA TREATED WITH RADICAL SURGICAL RESECTION AND INTENSIVE CHEMOTHERAPY: FINAL REPORT OF THE HEAD START I-III TRIALS, 1991–2009

Neuro-Oncology ◽

10.1093/neuonc/noy059.202 ◽

2018 ◽

Vol 20 (suppl_2) ◽

pp. i73-i73

Author(s):

Mohamed AbdelBaki ◽

Rajkumar Venkatramini ◽

Stergios Zacharoulis ◽

Sharon Gardner ◽

Girish Dhall ◽

...

Keyword(s):

Head Start ◽

Young Children ◽

Surgical Resection ◽

Final Report ◽

Intensive Chemotherapy ◽

Supratentorial Ependymoma ◽

Radical Surgical Resection

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First-Line Systemic Chemotherapy with Folfoxiri Followed by Radical Surgical Resection of Metastases for the Treatment of Unresectable Metastatic Colorectal Cancer Patients

Platinum and Other Heavy Metal Compounds in Cancer Chemotherapy ◽

10.1007/978-1-60327-459-3_32 ◽

2009 ◽

pp. 285-293

Author(s):

Enrico Vasile ◽

Gianluca Masi ◽

Fotios Loupakis ◽

Samanta Cupini ◽

Giacomo Giulio Baldi ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Colorectal Cancer ◽

Cancer Patients ◽

Surgical Resection ◽

Systemic Chemotherapy ◽

First Line ◽

Resection Of Metastases ◽

Colorectal Cancer Patients ◽

Radical Surgical Resection ◽

Unresectable Metastatic Colorectal Cancer

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A Case of Recurrent Rhabdomyosarcoma 11 Years after Radical Surgical Resection

Japanese Journal of Cardiovascular Surgery ◽

10.4326/jjcvs.40.184 ◽

2011 ◽

Vol 40 (4) ◽

pp. 184-187

Author(s):

Keisuke Watadani ◽

Takeshi Shimamoto ◽

Genichi Sakaguchi ◽

Nobushige Tamura ◽

Tatsuhiko Komiya

Keyword(s):

Surgical Resection ◽

Radical Surgical Resection

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EPCO-01. MOLECULAR PROFILING OF SPINAL CORD EPENDYMOMA

Neuro-Oncology ◽

10.1093/neuonc/noab196.000 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi1-vi1

Author(s):

Erika Yamazawa ◽

Shota Tanaka ◽

Genta Nagae ◽

Takayoshi Umeda ◽

Taijun Hana ◽

...

Keyword(s):

Spinal Cord ◽

Dna Methylation ◽

Methylation Status ◽

Neurofibromatosis Type ◽

Methylation Pattern ◽

Who Grade ◽

Spinal Ependymoma ◽

Fresh Frozen ◽

Spinal Cord Ependymoma ◽

The Difference

Abstract BACKGROUND Ependymomas are currently classified into 9 subgroups by DNA methylation profiles. Although spinal cord ependymoma (SP-EPN) is distinct from other tumors, diversity within SP-EPN is still unclear. Here, we used transcriptomic and epigenomic profiles to investigate the diversity among Japanese SP-EPN cases. MATERIALS AND METHODS We analyzed 57 SP-EPN patients (32 males and 25 females, aged from 18 to 78 years, median: 52), including two cases of neurofibromatosis type 2, five cases of grade 3 (WHO grade). We obtained transcriptome (RNA-seq) and DNA methylation (Infinium Methylation EPIC array) data from fresh frozen specimens of SP-EPN resected at the University of Tokyo Hospital and our collaborative groups. RESULTS Three cases had a previous intracranial ependymoma operation. Hierarchical clustering of the DNA methylation data showed that these three cases of intracranial origin as a different cluster from spinal origin. The 45 grade 2 spinal ependymoma showed a relatively homogenous methylation pattern. However, the methylation status of HOX gene cluster regions is compatible with the segment of origin, which reflects the cells of origins are derived after the determination of segment identity. RNA sequencing of 57 cases revealed two subgroups within grade 2. Gene ontology analysis of differentially expressed genes suggested the difference in metabolic state such as rRNA translation and mitochondrial respiration between the two expression subgroups. CONCLUSION Epigenetic analysis indicated the accurate body segment origin of SP-EPN. We observed that metabolic states could divide grade 2 spinal cord ependymoma into 2 subgroups and will present the relationship to clinicopathological information.

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