Risk factors for the recurrence of world health organization grade Ⅱ ependymomas of spinal cord in adults after microsurgical resections: A retrospective study of 118 patients in a single center

Abstract

ObjectiveTo identify the risk factors for recurrence of World Health Organization (WHO) grade Ⅱ ependymomas of spinal cord in adults after microsurgical resections. Patients and MethodsA total of 118 adult patients diagnosed with WHO grade Ⅱ ependymomas of spinal cord at west china hospital from January 2010 to December 2016 were reviewed retrospectively. To identify the risk factors for recurrence, we performed univariate analyses and multivariate logistic regression analyses successively. ResultsTwelve patients had a recurrence with a median recurrence time of 30 months [inter-quartile range (IQR) 23.5–75.5 months]. Univariate analysis showed that age (p = 0.030), STR (p < 0.001), index of Ki-67 (p = 0.004), and Vimentin (+, p = 0.004) were associated with postoperative recurrence of ependymomas of spinal cord in adults, while univariate analysis showed that only STR [odds ratio (OR) = 18.838, 95 % confidence interval (CI): 3.068−115.673; p = 0.002], index of Ki-67 (OR = 1.381, 95 % CI: 1.021−1.868; p = 0.036), Vimentin (+; OR = 6.706, 95 % CI: 1.218−36.928; p = 0.029) were independent risk factors for recurrence. ConclusionsThe recurrence rate of WHO grade Ⅱ ependymomas of spinal cord in adults was about 13.6 %. Subtotal resection is a critical risk factor for recurrence. A high index of Ki-67 is another independent risk factor for recurrence. Positive Vimentin may also play a role in this process. GTR is very important to prevent recurrence after operation if it is safe to conduct. In cases with higher index Ki-67 and Vimentin (+), close follow-ups are necessary.