Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro-Oncology Group

Perilongo, Giorgio; Massimino, Maura; Sotti, Guido; Belfontali, Tiziana; Masiero, Lucia; Rigobello, Luca; Garrè, Maria Luisa; Carli, Modesto; Lombardi, Fabrizio; Solero, C. L.; Sainati, Laura; Canale, Virginia C.; Prever, Adalberto Brach del; Giangaspero, Felice; Andreussi, L.; Mazza, Carlo; Madon, E

doi:10.1002/(sici)1096-911x(199708)29:2<79::aid-mpo3>3.0.co;2-o

Cited by 181 publications

(87 citation statements)

References 22 publications

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“…Histological grade was calculated as a prognostically significant factor in nine of the 32 studies analyzed. 4,10,12,20,25,30,[32][33][34] One additional study found necrosis as a significant prognostic factor, but this study did not find anaplastic histology to be prognostically significant. 7 Eight of nine studies found that histological grade was a significant prognostic factor in terms of EFS or progressionfree survival.…”

Section: Influence Of Histological Gradementioning

confidence: 67%

“…Many studies had Grade II ependymomas that were up to two to three times more frequent than Grade III tumors. 3,4,6,9,11,14,15,17,20,22,24,25,30 In some studies this ratio was almost equal, 13,19,[33][34][35] while in others there were far more Grade III than Grade II ependymomas. 12,26,28,29,31,32 In one study of ependymomas in children under 5 years of age, the authors reported eight Grade II and 60 Grade III ependymomas.…”

Section: Pediatric Posterior Fossa Ependymomas T Tihan Et Almentioning

confidence: 96%

“…Among 18 studies where the effect of age on survival was analyzed, 12 studies reported age at diagnosis as an independent prognostic factor. 4,7,[9][10][11]13,20,22,24,25,33,34 Six of these studies considered the cut-off for age groups as 3 years, two as 4 years, and one as 5 years of age. In one study, age was calculated as a continuous variable, and in another study of children younger than 3 years, the cut-off between two age groups was 2 years of age (24 months).…”

Section: Pediatric Posterior Fossa Ependymomas T Tihan Et Almentioning

confidence: 99%

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The prognostic value of histological grading of posterior fossa ependymomas in children: a Children's Oncology Group study and a review of prognostic factors

et al. 2008

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We performed a retrospective analysis of 96 pediatric posterior fossa ependymomas in order to determine the prognostic value of histological grade based on the current WHO grading scheme. The patients were selected among Children's Oncology Group (previously Pediatric Oncology Group-POG) patients enrolled in clinical trials, and on the basis of central pathology review, location, and age. We excluded entities such as subependymoma, myxopapillary, or clear-cell ependymoma, after a consensus diagnosis by three neuropathologists. A total of 66 males and 30 females with a median age of 48 months were identified. The group was analyzed to determine the effects of histological grade, age, gender, and extent of resection on event-free and overall survival. Our results showed that extent of resection, age, and histological grade were independent prognostic variables for event-free survival. The relative risk for extent of resection and histological grade was calculated as 3.59 (Po0.001) and 3.58 (Po0.001), respectively. Overall survival significantly correlated with extent of resection and age, but not with histological grade. We compared our results with peer-reviewed publications on pediatric intracranial ependymomas in the English language between 1990 and 2005. Selection criteria identified 32 manuscripts involving 1444 patients. Extent of resection was a significant factor in 21, age in 12, and histological grading in nine of these studies. Other factors reported to be significant by more than one study included tumor location and radiation treatment. Our findings suggest that histological grade (WHO Grade II vs III) is an independent prognostic indicator for event-free survival, but may not be so for overall survival in pediatric posterior fossa ependymomas. We believe that an accurate assessment of the prognostic value of histological grade depends on the selection of a well-characterized clinical cohort of sufficient size, and the inclusion of relevant histological criteria as outlined in the WHO classification scheme.

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Section: Influence Of Histological Gradementioning

confidence: 67%

Section: Pediatric Posterior Fossa Ependymomas T Tihan Et Almentioning

confidence: 96%

Section: Pediatric Posterior Fossa Ependymomas T Tihan Et Almentioning

confidence: 99%

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The prognostic value of histological grading of posterior fossa ependymomas in children: a Children's Oncology Group study and a review of prognostic factors

et al. 2008

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“…Historically, children below 3 years of age and infratentorial ependymomas have been associated with a poor outcome (6,(22)(23)(24). It remains unclear whether this reflects tumor biology, the surgical inaccessibility of posterior fossa tumors, which are more prevalent in younger children, or the avoidance of adjuvant radiotherapy in early life resulting from concerns about long term clinical sequelae (4,14,23,25,26).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have shown conflicting results about an association between grade and patient outcome (1,4,5,13,14,18,22,(27)(28)(29)(30)(31).…”

Section: Introductionmentioning

confidence: 99%

Pediatric Ependymoma: Biological Perspectives

Kilday

Rahman

Dyer

et al. 2009

Molecular Cancer Research

168

204

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Pediatric ependymomas are enigmatic tumors that continue to present a clinical management challenge despite advances in neurosurgery, neuroimaging techniques, and radiation therapy. Difficulty in predicting tumor behavior from clinical and histological factors has shifted the focus to the molecular and cellular biology of ependymoma in order to identify new correlates of disease outcome and novel therapeutic targets. This article reviews our current understanding of pediatric ependymoma biology and includes a meta-analysis of all comparative genomic hybridization (CGH) studies done on primary ependymomas to date, examining more than 300 tumors. From this meta-analysis and a review of the literature, we show that ependymomas in children exhibit a different genomic profile to those in adults and reinforce the evidence that ependymomas from different locations within the central nervous system (CNS) are distinguishable at a genomic level. Potential biological markers of prognosis in pediatric ependymoma are assessed and the ependymoma cancer stem cell hypothesis is highlighted with respect to tumor resistance and recurrence. We also discuss the shifting paradigm for treatment modalities in ependymoma that target molecular alterations in tumor-initiating cell populations. (Mol Cancer Res 2009;7(6):765-86)

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Intracranial ependymomas in children: A critical review of prognostic factors and a plea for cooperation

Bouffet

Perilongo

Cañete

et al. 1998

Med. Pediatr. Oncol.

173

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Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro-Oncology Group

Cited by 181 publications

References 22 publications

The prognostic value of histological grading of posterior fossa ependymomas in children: a Children's Oncology Group study and a review of prognostic factors

The prognostic value of histological grading of posterior fossa ependymomas in children: a Children's Oncology Group study and a review of prognostic factors

Pediatric Ependymoma: Biological Perspectives

Intracranial ependymomas in children: A critical review of prognostic factors and a plea for cooperation

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