Infratentorial ependymomas in childhood: prognostic factors and treatment

Nazar, Gonzalo; Hoffman, H J; Le, Becker; Jenkin, Derek; Humphreys, Robin P.; Hendrick, E B

doi:10.3171/jns.1990.72.3.0408

Cited by 272 publications

(180 citation statements)

References 46 publications

Supporting

Mentioning

164

Contrasting

Unclassified

Order By: Relevance

“…18 Nonetheless, the role of RT in treating Grade 2 ependymoma is controversial. In fact, the impact of RT on survival is not clearly supported by consistent statistical data, as no randomized trial has been conducted and retrospective studies have been uncontrolled or involved comparisons with historical controls, 20,29,35 while data on survival after surgery alone are severely limited in modern series.…”

Section: Treatmentmentioning

confidence: 99%

“…Recently, a number of smaller series have reported positive outcomes in children 20,27,28,[35][36][37][38][39][40] or adults 15 with totally resected Grade 2 intracranial ependymoma who did not receive RT after surgery. Reserving RT for recurrent disease appears to be an attractive strategy for patients with Grade 2 ependymoma, provided that the behavior of this malignancy is similar to that of lowgrade glioma, in which no detrimental impact on OS was observed when a 'wait and see' policy was followed after surgery.…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Reni

Brandes

Vavassori

et al. 2004

Cancer

107

View full text Add to dashboard Cite

BACKGROUNDThe current analysis of outcomes in a large series of adult patients with intracranial ependymal tumors contributes to the characterization of the primary prognostic factors and to the therapeutic management of this rare disease, for which limited information is available in the literature.METHODSThe authors analyzed data on patient and tumor characteristics, treatment, and survival in a series of 70 patients age > 17 years with pathologic diagnoses of brain ependymal tumors from 4 institutions.RESULTSThe 5‐ and 10‐year overall survival (OS) rates (± standard errors) were 67% ± 6% and 50% ± 8%, respectively. The 5‐ and 10‐year failure‐free survival (FFS) rates were 43% ± 7% and 24% ± 6%, respectively. Younger age and infratentorial tumor location were associated with longer survival. Among patients with Grade 2 ependymoma (n = 51), 21 (41%) received no postsurgical treatment. These 21 patients had a 5‐year OS rate of 78% ± 10% and a 10‐year OS rate of 68% ± 13%; the 5‐ and 10‐year FFS rates for these patients were 47% ± 12% and 12% ± 11%, respectively. Twenty‐six patients with Grade 2 ependymoma (51%) received postoperative radiotherapy (RT). These 26 patients had a 5‐year OS rate of 71% ± 9% and a 10‐year OS rate of 59% ± 11%; the 5‐ and 10‐year FFS rates for these patients were 54% ± 10% and 34% ± 10%, respectively. Among patients with Grade 2 ependymoma, neither OS nor FFS differed significantly between those who did not receive postoperative RT and those who did; however, these two groups were heterogeneous with respect to prognostic factors. On multivariate analysis, RT use exhibited a trend toward improved OS and was significantly predictive of improved FFS.CONCLUSIONSThe current analysis does not rule out the possibility that deferral of RT at the time of recurrence could have a detrimental effect on FFS or OS in patients with Grade 2 ependymoma, regardless of the degree of ablation. The role of postoperative RT for patients who undergo imaging‐based macroscopic total resection remains to be addressed. Cancer 2004. © 2004 American Cancer Society.

show abstract

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Reni

Brandes

Vavassori

et al. 2004

Cancer

107

View full text Add to dashboard Cite

show abstract

“…Various factors have been reported to influence prognosis, though clinical research in this area has produced many conflicting results. However, gross surgical resection and the use of radiotherapy have been consistently associated with enhanced event-free and overall survival (Nazar et al, 1990;Sutton et al, 1990;Healey et al, 1991;Vanuytsel et al, 1992;Ferrante et al, 1994;Pollack et al, 1995;Bouffet et al, 1998;Robertson et al, 1998;Horn et al, 1999;Grill et al, 2001). Histological features of anaplasia, such as mitoses, microvascular proliferation and necrosis, serve as indicators of biological behaviour in other gliomas, including diffuse astrocytic tumours and oligodendrogliomas (Cohadon et al, 1985;Burger and Green, 1987;Ellison, 1998).…”

mentioning

confidence: 99%

Genetic abnormalities detected in ependymomas by comparative genomic hybridisation

et al. 2002

View full text Add to dashboard Cite

Using comparative genomic hybridisation, we have analysed genetic imbalance in a series of 86 ependymomas from children and adults. Tumours were derived from intracranial and spinal sites, and classified histologically as classic, anaplastic or myxopapillary. Ependymomas showing a balanced profile were significantly (P50.0005) more frequent in children than adults. Profiles suggesting intermediate ploidy were common (44% of all tumours), and found more often (P50.0005) in tumours from adults and the spinal region. Loss of 22q was the most common specific abnormality, occurring in 50% of spinal (medullary) ependymomas and 26% of tumours overall. Genetic profiles combining loss of 22q with other specific abnormalities -gain of 1q, loss of 6q, loss of 10q/10, loss of 13, loss of 14q/14 -varied according to site and histology. In particular, we showed that classic ependymomas from within the cranium and spine have distinct genetic profiles. Classic and anaplastic ependymomas with gain of 1q tended to occur in the posterior fossa of children and to behave aggressively. Our extensive data on ependymomas demonstrate significant associations between genetic aberrations and clinicopathological variables, and represent a starting point for further biological and clinical studies.

show abstract

“…They account for about 2-6% of CNS tumours [13,18], and for 60-70% of spinal cord tumours [5]. Ependymomas with several morphological features and different biological behaviour have been described [5].…”

Section: Introductionmentioning

confidence: 99%

Giant cell ependymoma of the cervical spinal cord: case report and review of the literature

et al. 2008

View full text Add to dashboard Cite

Ependymomas account for 2-6% of all central nervous system neoplasms. They develop from the ependymal cells that line the ventricular cavities of the brain and the central canal of the spinal cord, as well as from ependymal clusters in the filum terminale. Giant cell ependymoma (GCE) is a rare subtype, with few cases reported, mostly in the brain. We describe the case of a cervical spinal cord ependymoma with pleomorphic giant cells and focal calcifications occurring in a 25-year-old woman. Magnetic resonance imaging revealed a large multicystic and partially enhancing intramedullary tumour extending from C2 to C5. Intraoperative analysis of frozen section tissue fragments suggested a malignant tumour; however, an obvious cleavage plane was present around most of the mass, and a macroscopically complete tumour removal could be achieved. Subsequently, paraffin sections and immunohistochemical investigations revealed unequivocal evidence of a GCE with focal calcifications. This case, the second giant-cell ependymoma to be described in the spinal cord and the first with focal calcifications, highlights the features of GCE and the discrepancy between the worrisome histological appearance, the surgical findings and the clinical relatively good prognosis.

show abstract

Infratentorial ependymomas in childhood: prognostic factors and treatment

Cited by 272 publications

References 46 publications

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Genetic abnormalities detected in ependymomas by comparative genomic hybridisation

Giant cell ependymoma of the cervical spinal cord: case report and review of the literature

Contact Info

Product

Resources

About