P11.22.B ANALYSIS OF FACTORS RELATED TO POSTOPERATIVE RECURRENCE AND PROGNOSIS ABOUT HIGH GRADE SPINAL CORD GLIOMAS

Abstract

Abstract BACKGROUND High grade spinal glioma (HGSG), an extremely rare tumor, accounts for about 7-30% of spinal glioma. Its incidence is only 0.22/100000. The tumor has a rapid clinical progression and a poor prognosis, with a median survival time of 12-24 months. In previous studies on the prognosis of HGSG, the factors related to the prognosis are quite different due to inconsistent tumor classification and diagnosis criteria. It is rarer in the study of postoperative recurrence. Therefore, various factors limit the clinician’s judgment on the factors related to the recurrence and prognosis of HGSG after surgery. MATERIAL AND METHODS In this study, the clinical data of 44 patients who were pathologically diagnosed with HGSG and admitted to the Department of Neurosurgery of Beijing Tsinghua Changgung Memorial Hospital from January 1, 2015 to January 1, 2020 were retrospectively analyzed. The postoperative recurrence and death were considered as the research end time, the individual characteristics, imaging characteristics, pathological characteristics, age in treatment, gender, McCormick score, tumor location, WHO grade, tumor volume, degree of resection, radiotherapy, chemotherapy, and H3K27M expression, Ki-67 index, and P53 expression were included in the COX regression model for the univariate and multivariate analysis. The factors related to the recurrence and prognosis of HGSG after surgery were further explored. RESULTS The median recurrence-free duration of 44 patients with HGSG was 13.0 months, and the recurrence-free rates of 6 months and 1 year after surgery were 75.0% and 51.9%; the median survival time of the enrolled patients was 21.0 months. The multivariate COX regression analysis on the recurrence of HGSG after surgery showed that the risk of the recurrence was higher in the III-IV group than that the I-II group for the McCormick score ( p=0.001). For WHO grade, the risk of the recurrence was higher in the IV group than that in the III group (p=0.029). The multivariate COX regression analysis on that survival after HGSG surgery showed that the risk of the death was higher in the III-IV group than that in the I-II group for the McCormick score (p=0.006), and the risk of the death was higher for the tumor in the cervical segment than that in the cervical thoracic segment ( p=0.005), thoracic segment ( p=0.003), thoracolumbar segment ( p=0.011). The risk of the death was higher in the H3K27M positive group ( p=0.014) than that in the H3K27M negative group. 0.049). CONCLUSION HGSG, as a highly malignant tumour, exhibits rapid progression even after surgical treatment. For future post-operative recurrence and prognosis determination of HGSG, there is a need to focus on assessing the preoperative spinal cord functional status, tumour location, WHO classification and H3K27M mutation status to assist clinicians in giving the best treatment plan.