Epidemiology Of Primary Spinal Cord Tumours In Isfahan, Iran, 1992 2004

2416 words - 10 pages

Introduction
Primary spinal cord tumors (PSCTs) comprise approximately four percent of primary CNS tumors. They are typically classified into two major groups: Extradural and intradural. Extradural ones usually arise from adjacent connective tissues. In contrast, Intradural tumors originate from neural, glial, or meningial cells in the spinal cord and are subcategorized into Intra- and extra-medullary.
Regarding the rarity, little population-based studies are available for PSCTs. [1] Most of these studies lack uniform pathologic criteria and rarely include non malignant cases. [2] A solid fund of knowledge on the clinical characteristics of each type of tumor can help prompting the process of diagnosis, management, treatment planning and estimating prognosis for spinal cord tumors. [3,4]
We intended to provide a view on epidemiology of PSCTs in Isfahan in order to set a benchmark of their clinical presentations and current management in Iranian population. Each histological subtype shall be discussed separately.

Materials and Methods
In this descriptive study, we retrospectively investigated primary spinal cord tumors in Isfahan province. Tumor registries of three major health care centers in Isfahan city (Al-Zahra, Kashani, and Sayed-Al-Shohada hospitals) were explored for cases diagnosed during the period September 1992 through September 2004. Diagnosis was established by biopsy subsequent to magnetic resonance imaging (with gadolinium-contrast).
Patient demographic/clinical data (gender, age at onset, presenting symptoms) was collected using patients’ file and via phone interviews. The male-to-female rate ratios were calculated by dividing frequency rates for male cases by those for female cases. The patients were categorized into four age groups: Children (0-19y); younger adults (20-44y); older adults (45-64y); and seniors (≥ 65y). The histology groupings are largely consistent with the world health organization categories for CNS neoplasms. [5]
Initial symptoms were categorized in 4 groups: local pain (neck pain, thoracic back pain, low back pain); muscle weakness (decreased limb force, dysarthria, dysphagia); sensory dysfunction (paresthesia, sensory loss, impaired temperature and vibration sensation); and referral pain (radicular limb pain, e.g. shoulder pain).
Data on tumor characteristics (histological type, grade, invasiveness, anatomical site, extension) and treatment modalities was also collected from the surgery/pathology notes in the patient file. Based on tumor site in relation to the thecal sac, tumors were categorized into three classes; Intradural intramedullary, intradural extramedullary, and extradural. The tumors were also classified according to their anatomical location along the spinal cord to cervical, thoracic, lumbar, sacral, and filum terminalis.
Three-, five-, seven-, and ten-year survival rates following diagnosis were reported. Malignant cases who were no...

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