Adult intramedullary gliomas

auteurs

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

mots-clés

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

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.

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