Clinical characteristics and prognostic factors of primary spinal subependymoma: a single-center cohort study and systematic review.

Purpose: This study analyzed spinal subependymoma (SP-SE) cases to evaluate treatment outcomes and identify factors influencing patient outcomes.

Method: Clinical data from our institution, along with relevant literature, were reviewed and summarized. Univariate and multivariate logistic regression analyses were conducted to assess factors impacting the prognosis of patients with primary spinal ependymomas.

Results: Our cohort included 16 males and 11 females, with a mean age of 46.2 ± 12.1 years. Tumors most commonly involved the thoracic spinal cord (37.0%) and an average of 4.8 segments. Approximately half of the tumors exhibited intramedullary to extramedullary growth (48.1%), and the tumors were predominantly eccentric in growth (85.2%). The median symptom duration was 48.0 months (IQR: 18.0-78.0 months), with limb weakness as the most frequent symptom. The median follow-up period was 61.0 months (IQR: 26.0-96.0 months). At the final follow-up, tumor regrowth occurred in 1 patient (3.7%), and 9 patients (33.3%) achieved good neurological outcomes (modified McCormick Scale [MSS] grades I). Multivariate logistic regression analysis revealed that tumors located at the T3-9 vertebral level were associated with worse postoperative neurological function (OR: 0.070, 95% Confidence Interval [CI]: 0.006-0.826, P = 0.035). Additionally, although the difference was not statistically significant, male gender also showed a trend towards an association with worse postoperative neurological function (OR: 0.126, 95% CI: 0.014-1.119, P = 0.063).

Conclusion: SP-SE generally follows a benign clinical course with favorable long-term survival. However, tumors located at T3-T9 and male patients tend to have worse postoperative neurological outcomes, requiring special attention during treatment.