A prospective study of outcome predictors of intramedullary spinal cord tumors

Abstract

Objectives: The objective of this study was to evaluate the outcomes of intramedullary spinal cord tumor (IMSCT) and the predictive factors that affected the outcomes. We also assessed the change in the health-related quality of life (HRQOL) of the patient's postsurgery during the follow-up period. Methods: This prospective study was done on 57 patients of IMSCT for a period of 3 years. Details regarding demography, clinical symptoms, histopathology grades/types, surgery performed, and the HRQOL (the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30) were noted. The outcome measures included mortality, neurological status (McCormick scale), and change in the HRQOL over a period of 6 months of follow-up. The data were entered in MS Excel and analyzed with P < 0.05 as significant. Results: Among the 57 patients, 42 (73.68%) had low-grade, 12 (21.05%) had high-grade, and 3 (5.26%) had unclassified metastatic tumors. Postoperatively, outcomes according to McCormick grade were same in 30 (52.63%) patients, worse in 15 (26.32%), and better in 12 (21.05%) patients. One patient died due to recurring seizures after metastasis. Histopathological type and surgical resection showed a significant association with McCormick grade (P < 0.05). The symptoms of paresthesia, motor weakness, and bladder/bowel involvement were significant risk factors for adverse outcomes with an odds ratio of 28.488, 6.077, and 4.035, respectively (P < 0.05). There was a significant improvement in the global quality of life of the patients after the surgery with significant improvement in emotional function, symptoms, and pain scores but a decrease in the physical functions (P < 0.05). Conclusion: The outcomes of patients with IMSCT are significantly affected by histology type, preoperative functional grade, and presenting symptoms.