Adult intramedullary gliomas

C. Campello (1) , F. Parker (2) , S. Slimani (2) , A. Le Floch (3) , A. Herbrecht (2) , N. Aghakhani (2) , C. Lacroix (2) , H. Loiseau (4) , J. P. Lejeune (5) , Gilles Perrin (6) , J. Honnorat (6) , H. Dufour (7) , O. Chinot (1) , D. Figarella (8) , L. Bauchet (9) , H. Duffau (9) , M. Lonjon (10) , Pierre Labauge (11) , M. Messerer (2) , J. P. Daures (3) , P. Fabbro (3) , B. Ducot (2)

1 Neuro-Oncologie [Hôpital de la Timone - APHM]
2 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
3 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
4 CHU Bordeaux
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
7 TIMONE - Hôpital de la Timone [CHU - APHM]
8 ACPNP - Service d'Anatomo-Cyto-Pathologie et de NeuroPathologie [Hôpital de la Timone - APHM]
9 INM - Institut des Neurosciences de Montpellier
10 CHU - Hôpital Pasteur [Nice]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]

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.

Mots clés: Chemotherapy; Chirurgie; Chimiothérapie; Gliomes intramédullaires; Intramedullary gliomas; Radiotherapy; Outcome; Radiothérapie; Surgery; Évolution

Domaines: Sciences du Vivant [q-bio]

C. Campello, F. Parker, S. Slimani, A. Le Floch, A. Herbrecht, et al.. Adult intramedullary gliomas. Neurochirurgie, 2017, 63 (5), pp.381--390. ⟨10.1016/j.neuchi.2016.10.003⟩. ⟨hal-01761506⟩