Gavin Quigley D, Farooqi Naeem, Pigott Timothy J D, Findlay Gordon F G, Pillay Robin, Buxton Neil, Jenkinson Michael D
Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool L9 7LJ, UK.
Eur Spine J. 2007 Mar;16(3):399-404. doi: 10.1007/s00586-006-0168-y. Epub 2006 Jul 25.
The aim of this study was to determine predictors of functional outcome and survival in a retrospective cohort of spinal cord ependymomas treated at a single institution. Twenty-six patients who underwent treatment of spinal cord ependymoma at a single institution were retrospectively analysed. The clinicopathological features were reviewed and correlated with functional outcome (measured using the Frankel grade), recurrence (clinical or radiological), progression-free survival (PFS) and overall survival (OS). Seventy-nine percent of patients with complete excision had maintained or improved functional outcome, compared to 75% in the incomplete resection plus radiotherapy group. Patients with a good pre-operative Frankel grade tended to maintain their functional status, though this did not reach statistical significance (Fisher's Exact test, P = 0.090). Univariate analysis revealed that longer symptom duration prior to treatment was associated with poorer functional outcome (P = 0.006). Extent of resection and the use of adjuvant radiotherapy did not influence PFS or OS; however, early diagnosis and treatment are paramount in the management of spinal ependymoma if a good functional outcome is to be achieved.
本研究的目的是在一个单一机构治疗的脊髓室管膜瘤回顾性队列中确定功能预后和生存的预测因素。对在一个单一机构接受脊髓室管膜瘤治疗的26例患者进行回顾性分析。回顾临床病理特征，并将其与功能预后（采用Frankel分级测量）、复发（临床或影像学）、无进展生存期（PFS）和总生存期（OS）进行关联分析。完全切除的患者中有79%维持或改善了功能预后，而不完全切除加放疗组为75%。术前Frankel分级良好的患者倾向于维持其功能状态，尽管这未达到统计学意义（Fisher精确检验，P = 0.090）。单因素分析显示，治疗前症状持续时间较长与较差的功能预后相关（P = 0.006）。切除范围和辅助放疗的使用不影响PFS或OS；然而，若要获得良好的功能预后，早期诊断和治疗在脊髓室管膜瘤的管理中至关重要。
