| Institution: | 1. Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, 59, Bd Pinel, 69003 Lyon, France;2. Université de Lyon I, Université de Lyon, Lyon, France;3. Service d’Anatomo-pathologie, Hospices Civils de Lyon, Lyon, France;4. Unité d’Appui Méthodologique, Département de la Recherche Clinique et Innovation, Hospices Civils de Lyon, Lyon, France;5. Unité d’Appui Méthodologique, EPICIME, Cellule Innovation DRCI, Hospices Civils de Lyon, Lyon, France;1. Neurosurgery University Hospital Reims, 45, rue de Cognacq Jay, 51092 Reims, France;2. Endocrinology University Hospital Reims, Reims, France;1. Service de neurochirurgie, hôpital Pasteur 2, CHU de Nice, 30, avenue de la voie romaine, 06000 Nice, France;2. Université Côte d’Azur, Nice, France;3. Service d’ophtalmologie, hôpital Pasteur 2, Nice, France;4. Centre de ressources et de compétences Sclérose en Plaques (CRCSEP), hôpital Pasteur 2, Nice, France;5. Service d’ORL, IUFC, Nice, France;6. Service de radiologie, hôpital Pasteur 2, Nice, France;1. Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France;2. Department of Neurology, Rothschild Ophthalmologic Foundation, Paris, France;3. Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France;4. Department of Neurosurgery, Beaujon Hospital, Clichy, France;5. CNRS UMR7622 Sorbonne Université, Inserm ERL U1156, Paris, France;1. Department of pediatric neurosurgery, université de Lorraine, CHRU de Nancy, Nancy, France;2. Department of perinatal radiology and imaging, CHRU de Nancy, Nancy, France;3. Department of gynecology and obstetrics, CHRU de Nancy, Nancy, France;1. Department of neurosurgery, Istanbul Medipol University, School of medicine, TEM Goztepe exit, Bagcilar/Istanbul, Turkey;2. Department of pathology, Istanbul Medipol University, School of medicine, Istanbul, Turkey |
| Abstract: | ObjectiveTo define the prognostic factors for progression and to determine the impact of the histological grading (according to the World Health Organization) on the progression-free survival (PFS) of filum terminale ependymomas.MethodsA retrospective chart review of 38 patients with ependymoma of the filum terminale was performed, focusing on demographic data, preoperative symptoms, tumor size, quality of resection, presence of a tumor capsule, and histological grade.ResultsGross total resection (GTR) was achieved in 30 patients (78.9%). Histopathological analysis found 21 (55.3%) myxopapillary grade I ependymoma (MPE), 16 (42.1%) ependymoma grade II (EGII), and 1 (2.6%) ependymoma grade III. There was no significant difference between the mean ± SD volume of MPE (5840.5 ± 5244.2 mm3) and the one of EGII (7220.3 ± 6305.9 mm3, p = 0.5). The mean ± SD follow-up was 54.1 ± 38.4 months. At last follow-up, 30 (78.9%) patients were free of progression. In multivariate analysis, subtotal resection (p = 0.015) and infiltrative tumor (p = 0.03) were significantly associated with progression. The PFS was significantly higher in patients with encapsulated tumor than in patients with infiltrative tumor (log-rank p = 0.01) and in patients who had a GTR in comparison with those who had an incomplete resection (log-rank p = 0.05). There was no difference in PFS between patient with MPE and EGII (p = 0.1).ConclusionThe progression of ependymoma of the filum terminale highly depends on the quality of resection, and whether the tumor is encapsulated. Except for anaplastic grade, histopathological type does not influence progression. |
