PRO-QOL after gross total resection of spinal ependymoma: a retrospective study based on 3-year follow-up observations in a single center

Background: Although many studies have reported clinical outcomes of spinal ependymoma (SE) patients after gross total resection (GTR), the data about the patient reported outcomes of the quality of life (PRO-QOL) was limited.

Purpose: This study investigated the recovery process of PRO-QOL and explored the possibility of predicting the recovery of postoperative QOL by preoperative clinical indicators.

Methods: A retrospective analysis was performed in 71 SE patients who underwent GTR in our center from 2016 to 2022. The PRO-QOL data were collected by questionnaire, which included the EuroQol 5-Dimensions 5-Levels (EQ-5D-5 L) scale and visual pain analogue score (VAS). Factors affecting postoperative PRO-QOL deterioration was assessed by the univariate and multivariate analyses.

Results: 71 SE patients who undergone GTR were included and followed by mean of 36 months (range 27-58). The overall PRO-QOL recovered to a stable level 6 months after surgery, but the ability of self-care, as one of the dimensions of QOL, continued to improve up to one year after surgery. 21 (29.6%) patients reported that their QOL became worse at one year after surgery. The result of statistical analysis suggested that preoperative Modified McCormick Scale (MMS), the number of segments involved by the tumor and preoperative VAS score were identified as main preoperative variables for predicting QOL deterioration.

Conclusion: From the perspective of PRO-QOL, neurological rehabilitation should be continued for at least 6-12 months after GTR to the SE patients. For the preoperative patients with severe neurological damage, long-level intraspinal tumor and low VAS score, more cautious surgical considerations, more perioperative attention and earlier neurological intervention are necessary.