Intracranial ependymomas: Prognostic aspects

Abstract

According to the grading of brain tumors as proposed by the WHO in 1976, out of 128 ependymomas 83 tumors could be classified as grade II and 38 as grade III Only seven subependymomas were benign and could be assigned to grade I. In contrast to most series known from the literature, 73 ependymomas were located above the tentorium and only 55 in the posterior cranial fossa. The grade of malignancy rised with an increased distance from the ventricular level. Macroscopically complete exstirpations were usually possible in hemispheric ependymomas, whereas tumors arising from the floor of the fourth ventricle often allowed only a partial removal. The operative mortality in the infratentorial group was more than twice as that in the supratentorial group. Postoperative survival was predominantly dependent on the histologic grade of malignancy. The five year survival rate without recurrence was 57.4% in grade II ependymomas as compared to 24.1% in grade III ependymomas. It could be improved by postoperative radiation therapy in both groups of malignancy. The almost identical longterm results indicate that even in less malignant ependymomas new tumor growth will occur later on.

Outcomes of Malignant CNS Ependymomas: An Examination of 2408 Cases Through the Surveillance, Epidemiology, and End Results (SEER) Database (1973–2005)

“…Previous studies have found that the grade of the tumor had a significant prognostic value for the survival of the patient [2,13,33,41,47,48]. Among the histologic features evaluated in our study, tumor grade was associated with statistically significant survival differences in the univariate analysis.…”

Intracranial Ependymomas of Childhood: Current Management Strategies

“…Prognosis is generally poor; the 5-year overall survival rate is about 50% [23, 24, 25, 26, 27, 28, 29, 30]. No large prospective studies have evaluated treatment modalities and retrospective studies have small sample sizes and conflicting results in terms of outcome and identification of prognostic factors.…”

Treatment of ependymomas. Clinical and non-clinical factors influencing prognosis: a review

“…Percentages given in 16 Schro È der. 50 m series describing Intracranial ependymomas :Ernestus, 46 Di M arco, 63 W allner, 72 Chin. 9 r series describing spinal ependymomas:…”

“…Data obtained from series describing intracranial ependymomas, including supra-and infratentorial ependym omas in both adults and children. 7,23,27,29,46,59,63 C. Data obtained from series describing intracranial ependymomas in children only, including supra-and infratentorial ependymomas. 9,26,28,36,68,69,73 D. Data obtained from series describing spinal ependym omas in both adults and children.…”