IRCCS, "Neuromed", Pozzilli (IS), Italy.
Neurosurgery Division, NESMOS Department, A.O.U. "Sant'Andrea", Sapienza University - Rome, Rome, Italy.
World Neurosurg. 2019 Sep;129:245-253. doi: 10.1016/j.wneu.2019.05.206. Epub 2019 May 29.
Spinal myxopapillary ependymoma (sMPE) is an uncommon primary spinal neoplasm infiltrating the spinal cord, conus medullaris (CM), and nerve roots. It is associated with low resection and high recurrence rates. The purpose of this literature review is to evaluate the exact impact of the involvement of the CM and the role played by gross total resection (GTR) on overall survival (OS).
The English literature was systematically investigated using MEDLINE, the NIH Library, PubMed, and Google Scholar search engines with relevant queries. Case series reporting details concerning OS, GTR, and CM involvement rate were included, with a differential statistical weight given by the number of patients enrolled. A final cohort of 1602 clinical records was analyzed according to the 3 selected end point variables.
The average age was 36.44 ± 3.41 years, and the CM was involved in 28.4% ± 28.2% of cases. The average GTR rate was 53.94% ± 22.20%. Five- and 10-year OS rates were respectively available in 1170 and 1167 cases, with an average 5- and 10-year OS rate of 94.99% ± 3.87% and 92.31% ± 5.73%. By means of analyses performed both on aggregated and disaggregated data a strong positive statistical connection between GTR and increased OS was demonstrated despite the real clinical advantage could range as low as around 1% of increased OS rate.
Given the indolent sMPE behavior, it is difficult to evaluate the exact impact of GTR and CM involvement on OS; however, GTR could be associated with a limited survival advantage, whereas CM involvement could be associated with a survival disadvantage.
脊髓黏液乳头型室管膜瘤（sMPE）是一种罕见的原发性脊髓肿瘤，浸润脊髓、圆锥和神经根。它与低切除率和高复发率有关。本文综述的目的是评估圆锥受累和大体全切除（GTR）对总生存期（OS）的影响。
使用 MEDLINE、NIH 图书馆、PubMed 和 Google Scholar 搜索引擎，通过相关查询，对英文文献进行系统检索。纳入报告 OS、GTR 和圆锥受累率详细信息的病例系列，根据纳入的患者数量给予不同的统计权重。根据 3 个选定的终点变量分析了最终的 1602 例临床记录。
平均年龄为 36.44 ± 3.41 岁，圆锥受累率为 28.4% ± 28.2%。平均 GTR 率为 53.94% ± 22.20%。1170 例患者可获得 5 年和 10 年 OS 率，1167 例患者可获得平均 5 年和 10 年 OS 率，分别为 94.99% ± 3.87%和 92.31% ± 5.73%。通过对汇总和分解数据的分析，尽管实际的生存优势可能低至增加 1%左右的 OS 率，但 GTR 与增加的 OS 之间存在很强的统计学关联。
鉴于 sMPE 行为缓慢，很难评估 GTR 和圆锥受累对 OS 的确切影响；然而，GTR 可能与有限的生存优势相关，而圆锥受累可能与生存劣势相关。
