Clinical course of adult patients with ependymoma

Abstract

BACKGROUND: Ependymomas are a rare tumor in adults, and there are limited reports of the clinical course, treatment, and current health status of patients. METHODS: Patients with ependymoma completed an online survey regarding their diagnosis, treatment course, and current health status. Descriptive statistics were used to report the characteristics and degree of symptom severity. Correlations between demographic and clinical characteristics were explored with univariate analysis. RESULTS: One hundred eighteen adults participated, and there were more women (n ¼ 68) than men (n ¼ 50). The median age was 48 years (range, 22-77 years). Fifty-nine participants (48%) reported that they had not been able to work since their diagnosis, and 31% reported receiving disability benefits. Patients who had been treated for spine tumors had symptoms longer than those who had been treated for brain lesions (chi-square statistic, 7.294; P ¼ .026), and the majority had 3 symptoms before diagnosis. Most patients reported undergoing complete resection (brain lesions, 62%; spine tumors, 58%), and patients with spine tumors were less likely to have received additional treatment (chi-square statistic, 9.687; P ¼ .008). The majority had not had a recurrence and reported consulting a neurosurgeon for surveillance. Despite having stable disease and not receiving active treatment, most patients described moderate to severe symptoms, including fatigue (44%), numbness/tingling (39%), pain (36%), and disturbed sleep (34%) overall. Brain lesions were associated with altered vision (25%), difficulty concentrating (25%), weakness (19%), irritability (19%), difficulty speaking (19%), and understanding (17%); and spine lesions were associated with extremity weakness (55%), sexual dysfunction (48%), radiating pain (37%), and change in bowel pattern (35%). CONCLUSIONS: Treatment for adult patients with ependymoma is not standardized. Despite the low recurrence rate, patients reported significant symptoms and disability. Cancer 2011;117:5133-

Management and outcome analysis of conus and filum ependymoma: A tertiary center study

“…CFE can occur over a wide range of age groups; Sonneland et al reported a mean age of 36.4 years in the study analyzing MPE. [7] However, mean age can vary between 30 and 45 years in literature;[3101213] however, it mostly occurred in young adults with a mean age of 30.23 years in the current study. Male predominance was noted in our study (male: female 1:0.82), but similar gender predilection has not been observed previously.…”

“…Radiotherapy is also advocated in case of recurrence and even for piecemeal excision; however, these indications remain controversial. [37813161920] In 2011, Chao et al observed postoperative radiotherapy delayed recurrence in their study involving 37 cases myxopapillary[20] radiation therapy also been used in CNS metastasis; however, this is another area of controversy. Anecdotal reports of chemotherapy are available for cases of ependymomas in those nonoperable or recurrent cases and refractory to radiation therapy; however, most authors do not advocate chemotherapy as a routine.…”

A prognostic gene expression signature in infratentorial ependymoma

“…Despite histological similarities, ependymomas arising from the spinal cord and the infratentorial and supratentorial compartments of the central nervous system show diverse clinical behavior [2]. Several gene expression profiling studies have shown that ependymomas of different locations indeed have distinct expression profiles suggesting biological tumor heterogeneity [9; 15; 16; 24].…”

MicroRNA Regulation of Brain Tumour Initiating Cells in Central Nervous System Tumours

“…Ependymoma is a common pediatric and adult CNS tumour that is thought to originate from cells lining ventricular spaces and radial glial cells of the brain [ 138 – 140 ]. Although chemotherapy and radiotherapy comprise the standard regimen for the treatment of these patients, the patient outcome and 5-year survival remain poor due to recurrence [ 139 , 141 ].…”