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Analysis on therapeutic outcomes and prognostic factors of intracranial ependymoma: a report of 49 clinical cases in a single center

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Abstract

Although intracranial ependymoma is relatively rare, it is often associated with great clinical aggressiveness and poor overall survival. There are controversies over factors affecting the prognosis of the disease. The aim of this retrospective study was to evaluate factors that may affect the therapeutic outcome and prognosis of intracranial ependymoma by reviewing the medical records of 49 patients who were surgically treated in our hospital between 2001 and 2014. Univariate and multivariate analyses were performed to identify prognostic variables relative to patient and tumor characteristics, and treatment modalities. All 49 patients (24 men and 25 women; mean age 27.6 years) underwent surgical resection, of whom 14 patients also underwent postoperative radiotherapy. Local recurrence was found in 15 (48.8 %) patients, and 22 (51.2 %) patients died during the follow-up periods. The 5-year recurrence rate was 65 % and the survival rate was 51 %. The results of statistical analysis suggested that preoperative extraventricular drainage and surgical resection extent were prognostic factors related to progression-free survival, and that age, surgical resection extent and histological grade were closely associated with survival. Interestingly, there was a significant correlation between the symptom of hydrocephalus and age (P = 0.010), and patients with a better clinical status (KPS ≥ 80) were significantly associated with a lower WHO grade (P = 0.007). In conclusion, we confirmed that surgical resection extent was the major independent factor affecting both recurrence and survival of patients with intracranial ependymoma, while age and WHO grade were prognostic factors affecting survival but not recurrence.

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References

  1. Metellus P, Guyotat J, Chinot O et al (2010) Adult intracranial WHO grade II ependymomas: long-term outcome and prognostic factor analysis in a series of 114 patients. Neuro-oncology 12:976–984

    Article  PubMed Central  PubMed  Google Scholar 

  2. Nowak A, Marchel A (2012) Surgical treatment of intraventricular ependymomas and subependymomas. Neurol Neurochir Pol 46:333–343

    PubMed  Google Scholar 

  3. Sayegh ET, Aranda D, Kim JM et al (2014) Prognosis by tumor location in adults with intracranial ependymomas. J Clin Neurosci 21:2096–2101

    Article  PubMed  Google Scholar 

  4. Mørk SJ, Løken AC (1977) Ependymoma. A follow-up study of 101 cases. Cancer 40:907–915

    Article  PubMed  Google Scholar 

  5. Dutzmann S, Schatlo B, Lobrinus A et al (2013) A multi-center retrospective analysis of treatment effects and quality of life in adult patients with cranial ependymomas. J Neurooncol 114:319–327

    Article  PubMed  Google Scholar 

  6. Cage TA, Clark AJ, Aranda D et al (2013) A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas. J Neurosurg Pediatr 11:673–681

    Article  PubMed  Google Scholar 

  7. Metellus P, Barrie M, Figarella-Branger D et al (2007) Multicentric French study on adult intracranial ependymomas: prognostic factors analysis and therapeutic considerations from a cohort of 152 patients. Brain 130:1338–1349

    Article  PubMed  Google Scholar 

  8. Reni M, Brandes AA, Vavassori V et al (2004) A multicenter study of the prognosis and treatment of adult brain ependymal tumors. Cancer 100:1221–1229

    Article  PubMed  Google Scholar 

  9. Korshunov A, Golanov A, Sycheva R et al (2004) The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. Cancer 100:1230–1237

    Article  PubMed  Google Scholar 

  10. Massimino M, Buttarelli FR, Antonelli M et al (2009) Intracranial ependymoma: factors affecting outcome. Future Oncol (London, England) 5:207–216

  11. Vitanovics D, Balint K, Hanzely Z et al (2010) Ependymoma in adults: surgery, reoperation and radiotherapy for survival. Pathol oncol Res POR 16:93–99

    Article  PubMed  Google Scholar 

  12. Guyotat J, Signorelli F, Desme S et al (2002) Intracranial ependymomas in adult patients: analyses of prognostic factors. J Neurooncol 60:255–268

    Article  CAS  PubMed  Google Scholar 

  13. Pejavar S, Polley MY, Rosenberg-Wohl S et al (2012) Pediatric intracranial ependymoma: the roles of surgery, radiation and chemotherapy. J Neurooncol 106:367–375

    Article  PubMed  Google Scholar 

  14. Bouvier C, Bartoli C, Aguirre-Cruz L et al (2003) Shared oligodendrocyte lineage gene expression in gliomas and oligodendrocyte progenitor cells. J Neurosurg 99:344–350

    Article  CAS  PubMed  Google Scholar 

  15. Li TY, Chu JS, Xu YL et al (2014) Surgical strategies and outcomes of spinal ependymomas of different lengths: analysis of 210 patients. J Neurosurg Spine 21:249–259

    Article  PubMed  Google Scholar 

  16. Ailon T, Dunham C, Carret AS et al (2015) The role of resection alone in select children with intracranial ependymoma: the Canadian Pediatric Brain Tumour Consortium experience. Child’s Nerv Syst ChNS 31:57–65

    Article  Google Scholar 

  17. Bostrom A, Bostrom J, Hartmann W et al (2011) Treatment results in patients with intracranial ependymomas. Cent Eur Neurosurg 72:127–132

    Article  CAS  PubMed  Google Scholar 

  18. Robertson PL, Zeltzer PM, Boyett JM et al (1998) Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the children’s cancer group. J Neurosurg 88:695–703

    Article  CAS  PubMed  Google Scholar 

  19. Kim YJ, Kim JY, Lim do H et al (2013) Retrospective analysis of treatment outcome of pediatric ependymomas in Korea: analysis of Korean multi-institutional data. J Neurooncol 113:39–48

    Article  PubMed  Google Scholar 

  20. Ma L, Xiao SY, Liu XS et al (2012) Intracranial extraaxial ependymoma in children: a rare case report and review of the literature. Neurol Sci 33(1):151–154

    Article  CAS  PubMed  Google Scholar 

  21. Sanford RA, Gajjar A (1997) Ependymomas. Clin Neurosurg 44:559–570

    CAS  PubMed  Google Scholar 

  22. Timmermann B, Kortmann RD, Kuhl J et al (2005) Role of radiotherapy in anaplastic ependymoma in children under age of 3 years: results of the prospective German brain tumor trials HIT-SKK 87 and 92. Radiother Oncol 77:278–285

    Article  PubMed  Google Scholar 

  23. McGuire CS, Sainani KL, Fisher PG (2009) Both location and age predict survival in ependymoma: a SEER study. Pediatr Blood Cancer 52:65–69

    Article  PubMed  Google Scholar 

  24. Rousseau P, Habrand JL, Sarrazin D et al (1994) Treatment of intracranial ependymomas of children: review of a 15-year experience. Int J Radiat Oncol Biol Phys 28:381–386

    Article  CAS  PubMed  Google Scholar 

  25. Vanuystel LJ, Bessell EM, Ashley SE et al (1992) Intracranial ependymoma: long-term results of a policy of surgery and radiotherapy. Int J Radiat Oncol Biol Phys 23:313–319

    Article  Google Scholar 

  26. McLaughlin MP, Marcus RB Jr, Buatti JM et al (1998) Ependymoma: results, prognostic factors and treatment recommendations. Int J Radiat Oncol Biol Phys 40:845–850

    Article  CAS  PubMed  Google Scholar 

  27. Kawabata Y, Takahashi JA, Arakawa Y et al (2005) Long-term outcome in patients harboring intracranial ependymoma. J Neurosurg 103:31–37

    Article  PubMed  Google Scholar 

  28. Rogers L, Pueschel J, Spetzler R et al (2005) Is gross-total resection sufficient treatment for posterior fossa ependymomas? J Neurosurg 102:629–636

    Article  PubMed  Google Scholar 

  29. D’Elia A, Tropeano MP, Maiola V et al (2015) The etiology of low-grade gliomas: pathological and clinical considerations about radiation-induced low-grade gliomas. Neurol Sci 36(7):1091–1095

    Article  PubMed  Google Scholar 

  30. Simonetti G, Gaviani P, Innocenti A et al (2014) Update on treatment strategies for anaplastic glioma: a review of literature. Neurol Sci 35(7):977–981

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Research Projects of Science and Technology Commission of Shanghai Municipality, China (11DZ192130D, 13ZR1414200).

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    Authors and Affiliations

    1. Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

      Jingliang Ye, Junle Zhu, Peiqin Chen, Zhiping Wan, Feng Chen, Lei Zhang, Jun Qian & Chun Luo

    2. Department of Neurosurgery, CPLA No.98 Hospital, Huzhou, 313000, China

      Jingliang Ye

    3. Department of Radiology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China

      Jiayi Yan

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    1. Jingliang Ye
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    2. Junle Zhu
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    4. Peiqin Chen
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    9. Chun Luo
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    Correspondence to Chun Luo.

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    The authors declare no competing conflicts of interest.

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    J. Ye, J. Zhu and J. Yan contributed equally to this work, and all should be considered as first authors.

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    Ye, J., Zhu, J., Yan, J. et al. Analysis on therapeutic outcomes and prognostic factors of intracranial ependymoma: a report of 49 clinical cases in a single center. Neurol Sci 36, 2253–2261 (2015). https://doi.org/10.1007/s10072-015-2347-2

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