{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:53:02Z","timestamp":1791327182626,"version":"4.3.1"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Myxopapillary ependymomas (MPEs) are rare WHO Grade I tumors found in the conus medullaris, cauda equina, and filum terminale. Treatment generally consists of resection with or without adjuvant radiotherapy. Evidence-based guidelines for surgical management are lacking due to the rarity of this tumor.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>An English-language PubMed search was performed using the key words \u201cmyxopapillary\u201d and \u201cependymoma.\u201d Reports describing fewer than 3 patients or those lacking data on the extent of resection or radiotherapy were excluded. A total of 28 articles describing 475 patients met the authors' inclusion criteria. Patients were grouped by extent of resection and whether or not they underwent adjuvant radiotherapy. Differences in recurrence rates were assessed by chi-square test.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The overall recurrence rate was 15.5% in patients treated by gross-total resection (GTR) and 32.6% in patients treated by subtotal resection (STR), irrespective of whether they underwent adjuvant therapy (p &lt; 0.001). Regardless of the extent of resection, adjuvant radiotherapy was not associated with a decrease in recurrence rates. The overall recurrence rate was 15.6% in patients who underwent GTR and radiotherapy compared with 15.9% in patients who underwent GTR alone (p = 0.58), and it was 29.3% in patients who underwent STR and radiotherapy compared with 35.1% in those who underwent STR alone (p = 0.53). The difference between recurrence rates for patients who underwent GTR alone versus STR and radiotherapy was statistically significant (p = 0.02). Subgroup analysis demonstrated significantly higher recurrence rates in pediatric patients compared with adults (40.5% vs 23.4%, respectively; p = 0.02). Even in the setting of GTR alone, recurrence rates were higher in pediatric patients (65% vs 7.6%; p &lt; 0.001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Gross-total resection alone is associated with decreased recurrence rates compared with STR with or without radiotherapy. The authors' results suggest that treatment goals should include attempted GTR whenever possible. The observation that children benefitted from radiation therapy to a greater extent than did adults suggests that biological differences between tumors in these patient populations warrants more rigorous scientific studies.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.6.spine12927","type":"journal-article","created":{"date-parts":[[2013,8,23]],"date-time":"2013-08-23T14:01:48Z","timestamp":1377266508000},"page":"471-476","source":"Crossref","is-referenced-by-count":90,"title":["Tumor control after surgery for spinal myxopapillary ependymomas: distinct outcomes in adults versus children"],"prefix":"10.3171","volume":"19","author":[{"given":"William B.","family":"Feldman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Safaee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Parsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine12927","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.ijrobp.2012.05.001","article-title":"Management of pediatric myxopapillary ependymoma: the role of adjuvant radiation","volume":"85","author":"Agbahiwe","year":"2013"},{"key":"b2-spine12927","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s11060-006-9169-2","article-title":"Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M.D. Anderson Cancer Center","volume":"80","author":"Akyurek","year":"2006"},{"key":"b3-spine12927","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1038\/sc.2011.67","article-title":"Myxopapillary ependymoma: correlation of clinical and imaging features with surgical resectability in a series with long-term follow-up","volume":"49","author":"Al-Habib","year":"2011"},{"key":"b4-spine12927","series-title":"Pediatr Blood Cancer","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1002\/pbc.22614","article-title":"Adjuvant radiotherapy in the treatment of pediatric myxopapillary ependymomas","volume":"55","author":"Al-Halabi","year":"2010"},{"key":"b5-spine12927","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1002\/1097-0142(196604)19:4<585::AID-CNCR2820190418>3.0.CO;2-Y","article-title":"Myxopapillary ependymomas presenting in the soft tissue over the sacrococcygeal region","volume":"19","author":"Anderson","year":"1966"},{"issue":"4 Suppl","key":"b6-spine12927","series-title":"J Neurosurg","first-page":"261","article-title":"Resection of myxopapillary ependymomas in children","volume":"106","author":"Bagley","year":"2007"},{"key":"b7-spine12927","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s10143-009-0190-8","article-title":"Long term outcomes following surgical resection of myxopapillary ependymomas","volume":"32","author":"Bagley","year":"2009"},{"key":"b8-spine12927","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1227\/NEU.0b013e3182004c1e","article-title":"Surgery for spinal cord ependymomas: outcome and prognostic factors","volume":"68","author":"Bostr\u00f6m","year":"2011"},{"key":"b9-spine12927","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1038\/sj.bjc.6600180","article-title":"Genetic abnormalities detected in ependymomas by comparative genomic hybridisation","volume":"86","author":"Carter","year":"2002"},{"key":"b10-spine12927","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1227\/00006123-198402000-00015","article-title":"Myxopapillary ependymoma of the filum terminale and cauda equina in childhood: report of seven cases and review of the literature","volume":"14","author":"Chan","year":"1984"},{"key":"b11-spine12927","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3171\/2010.9.SPINE09920","article-title":"The role of adjuvant radiation therapy in the treatment of spinal myxopapillary ependymomas. 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