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Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients.

Publication ,  Journal Article
Karikari, IO; Nimjee, SM; Hodges, TR; Cutrell, E; Hughes, BD; Powers, CJ; Mehta, AI; Hardin, C; Bagley, CA; Isaacs, RE; Haglund, MM; Friedman, AH
Published in: Neurosurgery
January 2011

BACKGROUND: Surgical outcomes for intramedullary spinal cord tumors are affected by many variables including tumor histology and preoperative neurological function. OBJECTIVE: To analyze the impact of tumor histology on neurological outcome in primary intramedullary spinal cord tumors. METHODS: A retrospective review of 102 consecutive patients with intramedullary spinal cord tumors treated at a single institution between January 1998 and March 2009. RESULTS: Ependymomas were the most common tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), tumor histology (P = .005), and extent of resection (P < .0001) were all predictive of functional neurological outcomes. CONCLUSION: Tumor histology is the most important predictor of neurological outcome after surgical resection because it predicts resectability and recurrence.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

January 2011

Volume

68

Issue

1

Start / End Page

188 / 197

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Spinal Cord Neoplasms
  • Retrospective Studies
  • Recovery of Function
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
 

Citation

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MLA
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Karikari, I. O., Nimjee, S. M., Hodges, T. R., Cutrell, E., Hughes, B. D., Powers, C. J., … Friedman, A. H. (2011). Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients. Neurosurgery, 68(1), 188–197. https://doi.org/10.1227/NEU.0b013e3181fe3794
Karikari, Isaac O., Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, et al. “Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients.Neurosurgery 68, no. 1 (January 2011): 188–97. https://doi.org/10.1227/NEU.0b013e3181fe3794.
Karikari IO, Nimjee SM, Hodges TR, Cutrell E, Hughes BD, Powers CJ, et al. Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients. Neurosurgery. 2011 Jan;68(1):188–97.
Karikari, Isaac O., et al. “Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients.Neurosurgery, vol. 68, no. 1, Jan. 2011, pp. 188–97. Pubmed, doi:10.1227/NEU.0b013e3181fe3794.
Karikari IO, Nimjee SM, Hodges TR, Cutrell E, Hughes BD, Powers CJ, Mehta AI, Hardin C, Bagley CA, Isaacs RE, Haglund MM, Friedman AH. Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients. Neurosurgery. 2011 Jan;68(1):188–197.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

January 2011

Volume

68

Issue

1

Start / End Page

188 / 197

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Spinal Cord Neoplasms
  • Retrospective Studies
  • Recovery of Function
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male