Al-Mistarehi Abdel-Hameed, Zaitoun Khaled J, Javed Sania, Xia Yuanxuan, Hersh Andrew, Ghaith Abdul Karim, Weber-Levine Carly, Jiang Kelly, Khan Majid, Mendelson Benjamin, Ksabi Noa, Sciubba Daniel M, Gokaslan Ziya L, Jallo George I, Wolinsky Jean-Paul, Theodore Nicholas, Lubelski Daniel
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21281, USA.
Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
Cancers (Basel). 2025 Jun 24;17(13):2112. doi: 10.3390/cancers17132112.
Intramedullary spinal cord tumors (IMSCTs) account for 2-8% of all primary CNS tumors, with ependymal tumors astrocytic tumors and hemangioblastoma being the most prevalent. Due to scarcity of large-scale studies, we aim to provide insights into the long-term neurological and functional outcomes following their resection. A single-center study where retrospective review of all patients' medical records with IMSCT resection between October 2001 and March 2023 was conducted. Data on demographic characteristics, clinical presentations, and surgical outcomes were collected and analyzed. This study included 253 patients (57.7% male) with a mean age of 36.2 ± 19. The cohort comprised ependymal tumors (45.1%), astrocytic tumors (35.6%), hemangioblastoma (11.1%), and miscellaneous tumors ( = 21; 8.3%). Differences were observed in age at surgery ( < 0.001) and mortality ( = 0.002) across tumor types. Gross total resection was more frequently achieved in hemangioblastoma (96.4%) and ependymal tumors (82.5%) compared to astrocytic tumors (55.6%) ( < 0.001). Long-term postoperative improvements were significant, with reductions in numbness from 74.7% to 52.2%, pain from 42.2% to 25.7%, and bladder incontinence from 23.7% to 11.6%, particularly in ependymal tumors and astrocytic tumors. Kaplan-Meier analysis showed that patients with ependymal tumors had the highest overall survival rates (94.8% at 5 years, 86.7% at 10 years, 76.3% at 15 years, and 65.4% at 20 years) compared to hemangioblastoma (88.7% at 5 and 10 years, and 53.2% at 15 years) and astrocytic tumors (67.8% at 5 years, 58.1% at 10 and 15 years) ( = 0.001). : This study highlights the differences in survival and long-term functional outcomes among patients with IMSCTs based on tumor histology and grade.
脊髓髓内肿瘤（IMSCTs）占所有原发性中枢神经系统肿瘤的2%-8%，其中室管膜瘤、星形细胞瘤和血管母细胞瘤最为常见。由于缺乏大规模研究，我们旨在深入了解其切除术后的长期神经和功能结果。进行了一项单中心研究，对2001年10月至2023年3月期间所有接受IMSCT切除的患者的病历进行回顾性分析。收集并分析了人口统计学特征、临床表现和手术结果等数据。本研究纳入了253例患者（男性占57.7%），平均年龄为36.2±19岁。该队列包括室管膜瘤（45.1%）、星形细胞瘤（35.6%）、血管母细胞瘤（11.1%）和其他肿瘤（21例，占8.3%）。不同肿瘤类型在手术年龄（P<0.001）和死亡率（P=0.002）方面存在差异。与星形细胞瘤（55.6%）相比，血管母细胞瘤（96.4%）和室管膜瘤（82.5%）更常实现全切（P<0.001）。术后长期改善显著，麻木感从74.7%降至52.2%，疼痛从42.2%降至25.7%，膀胱失禁从23.7%降至11.6%，尤其是在室管膜瘤和星形细胞瘤中。Kaplan-Meier分析显示，与血管母细胞瘤（5年和10年时为88.7%，15年时为53.2%）和星形细胞瘤（5年时为67.8%，10年和15年时为58.1%）相比，室管膜瘤患者的总生存率最高（5年时为94.8%，10年时为86.7%，15年时为76.3%，20年时为65.4%）（P=0.001）。结论：本研究强调了基于肿瘤组织学和分级的IMSCT患者在生存和长期功能结果方面的差异。
