LAUSR

OBJECTIVE The present study aimed to perform a comprehensive data analysis of 47 consecutive patients treated in 8 years and to observe how clinical, radiological, and surgical factors impact on early and long-term outcomes, recurrence rate and survival. METHODS Clinical, radiological, and surgical data were collected retrospectively from the review of a prospectively collected database. The neurological disability was evaluated according to the Modified Ranking scoring system (MRS). Radiological data were obtained by direct measurement performed on MRI images. Univariate and multivariate statistical analysis were performed. RESULTS From 2008 to 2016, 47 consecutive patients underwent microsurgical resection of intramedullary lesions (28 males and 19 females, mean age 41.2 years). Ependymomas (53.2%), astrocytomas (14.9%), hemangioblastoma (14.9%), cavernous angioma (6.4%) were the most frequent tumors' histology. The mean follow-up duration was 69.3 months. Gross-total tumor resection was performed in 80.8% of cases. Forty-two patients (89.4%) were alive at last follow-up. Five-years overall survival and recurrence-free survival were respectively 92% and 82%. CONCLUSIONS Among the examined variables, age appeared to strongly correlate with outcomes: better chances of recovery and a good postoperative outcome were observed in younger patients. Surfacing lesions had a better early functional outcome than intramedullary located ones. Patients' preoperative neurological and functional status (MRS≤2) had a significant impact on late neurological outcome. Progression-free survival correlated with the extent of tumor resection. Surgery should be probably performed before patients' neurological decline, aiming to achieve maximal resection without compromising patients' quality of life.