Adult intramedullary gliomas

auteurs

• Campello C.
• Parker F.
• Slimani S.
• Le Floch A.
• Herbrecht A.
• Aghakhani N.
• Lacroix C.
• Loiseau H.
• Lejeune J. P.
• Perrin Gilles
• Honnorat J.
• Dufour H.
• Chinot O.
• Figarella D.
• Bauchet L.
• Duffau H.
• Lonjon M.
• Labauge Pierre
• Messerer M.
• Daures J. P.
• Fabbro P.
• Ducot B.

mots-clés

• Chemotherapy
• Chirurgie
• Chimiothérapie
• Gliomes intramédullaires
• Intramedullary gliomas
• Radiotherapy
• Outcome
• Radiothérapie
• Surgery
• Évolution

résumé

Intramedullary gliomas are rare tumors accounting for less than 4% of all primary central nervous system tumors. The aims of this retrospective multicenter study were to assess their natural outcome as well as management. METHODS AND MATERIALS: We studied 332~patients from 1984~to 2011. Histopathological examination revealed 72% ependymomas (94% were low grade tumors), 24% astrocytomas (29% were high grade tumors), 2.4% mixed gliomas and 1.7% oligodendrogliomas. RESULTS: The mean age at diagnosis was 42.4~years for ependymomas, with male predominance, versus 39.6~years for astrocytomas. Pain was the most common initial presentation. In 20% of cases, astrocytomas were biopsied alone, but more than 80% of ependymomas had surgical resection. Radiotherapy and chemotherapy were reserved for malignant tumors, especially if they were ependymomas. The 5-year survival rate was 76.8% for astrocytomas and 94.5% for ependymomas. Histology, functional status prior to surgery, and tumor grade are among the prognostic factors. CONCLUSION: Our study showed that surgical treatment of gliomas is well codified, at least for ependymomas, but adjuvant treatment continues to play a marginal role in the management even in astrocytomas, which are infiltrative tumors.

plus d'information