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Intracranial Ependymomas in Adult Patients: Analyses of Prognostic Factors

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Abstract

Objective: The goal of our study is to identify significant prognostic factors for a series of intracranial ependymomas in an adult population. Age, location, histology, preoperative clinical status, extent of resection and radiotherapy were examined.

Methods: Our series includes 34 patients. Ten tumors were located in the brain parenchyma, 5 in the lateral ventricle, 8 in the third and 11 in the fourth ventricle. Seventeen ependymomas were grades 2 and 17 were anaplastic. Surgical resection was gross-total in 27 patients and partial in 7.

Results: At a mean follow-up of 9 years (±1 year) 16 patients died and, among the 18 survivors 14 are in complete remission and 4 present a local recurrence. The 5- and 10-year overall survival rates were respectively 62% and 43%. The 5- and 10-year progression-free survivals were 47% and 43%. Univariate analysis revealed that location in the brain parenchyma and anaplasia are the only statistically significant predictors of poor outcome.

Conclusion: We can make out three groups of patients from our series: the first encompasses patients operated on for an intraparenchymal tumor, in all our cases an anaplastic ependymoma, with a 5-year rate of tumor-related deaths of 100%. The second group includes fourth ventricle ependymomas, which are mostly grade 2 tumors. They display a 10-year survival rate of 90%. Last group entails lateral and third ventricle ependymomas, of both low and high grade, with a 10-year survival rate of 60% for lateral ventricle and 35% for third ventricle tumors.

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Authors and Affiliations

  1. Service de Neurochirurgie B, Hôpital Neurologique ‘Pierre Wertheimer’, Lyon, France

    J. Guyotat, F. Signorelli, G. Madarassy & Ph. Bret

  2. Unité de biostatisques, Centre Léon Bérard, Inserm U 433, Lyon, France

    S. Desme

  3. Service de radiothérapie, Centre Léon Bérard, Lyon, France

    D. Frappaz

  4. Faculté de Médecine Laennec, Inserm U 433, Lyon, France

    M. Fevre Montange

  5. Service de Neuroanatomie, Hôpital Neurologique ‘Pierre Wertheimer’, Lyon, France

    A. Jouvet

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Guyotat, J., Signorelli, F., Desme, S. et al. Intracranial Ependymomas in Adult Patients: Analyses of Prognostic Factors. J Neurooncol 60, 255–268 (2002). https://doi.org/10.1023/A:1021136029072

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