engleski

Primary malignant spinal cord tumors: impact of extent of surgical resection on overall survival

Introduction: Primary malignant spinal cord tumors represent a minor subgroup of spinal cord tumor pathology with a poor prognosis. Various factors such as patient age, neurological status before surgery, tumor type and grade, extent of surgical resection and adjuvant therapy are reported to influence patient outcome. Our aim was to establish the role of extent of surgical resection as an independent parameter in outcome in these patients. Patients and methods: We performed a retrospective analysis of data from patients with primary intramedullary spinal cord tumors operated on at our institution between January 2006 and January 2011. We analyzed the influence of surgical radicality evidented intraoperatively and on short-term neuroradiological follow-up on patient outcome. Results: During the analyzed period 32 patients with primary intramedullary spinal cord tumors were operated on at our institution. Of these 7 (21, 9%) were patients with malignant tumors. Histological analysis revealed 4 glioblastoma multiforme (GBM), 2 anaplastic ependymomas (AE) and 1 primary spinal primitive neuroectodermal tumor (PNET). There were 4 male and 3 female patients. Mean age was 33 years (range, 7-65 years). Gross total resection was achieved in 5 patients and partial resection in 2 patients. Mean overall survival time was 24 months (60 months for PNET, 26, 5 months and for AE and 15 months for GBM). Two patients had intracranial dissemination of disease (GBM), associated with decreased survival. Conclusion: We found that poor clinical outcome in patients with primary malignant intramedullary spinal cord tumors is correlated only with tumor type and grade, and is not influenced by other factors, such as the extent of surgical resection.

Spinal cord; Toumors

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