Purpose: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.Methods: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.Results: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 (n= 21; 8.3%). Differences were observed in age at surgery (p< 0.001) and mortality (p= 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%) (p< 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) (p= 0.001).Conclusions: This study highlights the differences in survival and long-term functional outcomes among patients with IMSCTs based on tumor histology and grade.
目的：髓内脊髓肿瘤占所有原发性中枢神经系统肿瘤的2%至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，本研究旨在探讨髓内脊髓肿瘤切除术后患者的长期神经功能与功能预后。 方法：本研究为单中心回顾性研究，对2001年10月至2023年3月期间接受髓内脊髓肿瘤切除术的所有患者病历进行系统回顾。收集并分析人口学特征、临床表现及手术结果等数据。 结果：本研究共纳入253例患者（男性占57.7%），平均年龄为36.2±19岁。肿瘤类型包括室管膜瘤（45.1%）、星形细胞瘤（35.6%）、血管母细胞瘤（11.1%）及其他类型肿瘤（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）方面存在显著差异。血管母细胞瘤（96.4%）和室管膜瘤（82.5%）的全切除率显著高于星形细胞瘤（55.6%）（p<0.001）。术后长期功能改善显著：麻木症状从74.7%降至52.2%，疼痛从42.2%降至25.7%，尿失禁从23.7%降至11.6%，其中室管膜瘤和星形细胞瘤患者改善尤为明显。Kaplan-Meier生存分析显示，室管膜瘤患者总体生存率最高（5年94.8%、10年86.7%、15年76.3%、20年65.4%），显著优于血管母细胞瘤（5年和10年均为88.7%、15年53.2%）和星形细胞瘤（5年67.8%、10年及15年均为58.1%）（p=0.001）。 结论：本研究揭示了不同组织学类型及分级的髓内脊髓肿瘤患者在生存率和长期功能预后方面存在显著差异。
肿瘤(癌症)患者之家