Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina

Clinical article

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  • 1 Departments of Neurosurgery and
  • | 2 Medicine, University of Illinois at Chicago Medical Center, Chicago, Illinois;
  • | 3 Commission on Cancer, American College of Surgeons, Chicago, Illinois;
  • | 4 Neurosurgical Service, Massachusetts General Hospital, Boston, Massachusetts; and
  • | 5 Dardinger Neuro-Oncology Center and Department of Neurology, The Ohio State University Medical Center & James Cancer Hospital, Columbus, Ohio
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Object

Patients having a primary tumor of the spinal cord, spinal meninges or cauda equina, are relatively rare. Neurosurgeons encounter and treat such patients, and need to be aware of their clinical presentation, tumor types, treatment options, and potential complications. The purpose of this paper is to report results from a series of 430 patients with primary intraspinal tumors, taken from a larger cohort of 9661 patients with primary tumors of the CNS.

Methods

Extensive information on individuals diagnosed (in the year 2000) as having a primary CNS neoplasm was prospectively collected in a Patient Care Evaluation Study conducted by the Commission on Cancer of the American College of Surgeons. Data from US hospital cancer registries were submitted directly to the National Cancer Database. Intraspinal tumor cases were identified based on ICD-O-2 topography codes C70.1, C72.0, and C72.1. Analyses were performed using SPSS.

Results

Patients with primary intraspinal tumors represented 4.5% of the CNS tumor group, and had a mean age of 49.3 years. Pain was the most common presenting symptom, while the most common tumor types were meningioma (24.4%), ependymoma (23.7%), and schwannoma (21.2%). Resection, surgical biopsy, or both were performed in 89.3% of cases. Complications were low, but included neurological worsening (2.2%) and infection (1.6%). Radiation therapy and chemotherapy were administered to 20.3% and 5.6% of patients, respectively.

Conclusions

Data from this study are suitable for benchmarking, describing prevailing patterns of care, and generating additional hypotheses for future studies.

Abbreviations used in this paper:

ICD-O-2 = International Classification of Diseases for Oncology, second edition; KPS = Karnofsky Performance Scale; NCDB = National Cancer Database; PCE = Patient Care Evaluation; PNET = primitive neuroectodermal tumor.

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